Document Detail

Lymphoma resembling Hodgkin disease after posttransplant lymphoproliferative disorder in a liver transplant recipient.
MedLine Citation:
PMID:  8402478     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Posttransplant Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (PTLD) are B-cell derived tumors of polymorphic to monomorphic histologic type. Hodgkin disease (HD) is not considered part of this spectrum and rarely occurs in the post-transplant population. A liver allograft recipient is reported who had a PTLD develop that resolved after a reduction of immunosuppression. Several years later, the patient had a separate lymphoid tumor develop that resembled HD. The relationship between the two proliferations is analyzed. METHODS: Specimens were analyzed for T- and B-cell rearrangements and EBV status by Southern blot hybridization. Immunoperoxidase studies were performed to determine the phenotypic status of the lesions. In situ hybridization for EBV early RNA (EBER) was done to determine the distribution of virus-positive cells in tissue sections. RESULTS: Unique clonal rearrangements of immunoglobulin genes and EBV were seen in each instance. No evidence of T-cell receptor rearrangement was observed. EBER positivity was widespread in the PTLD and largely, but not exclusively, limited to the anaplastic cell in the HD-like tumor. The phenotype of these anaplastic cells was similar to that described for Reed-Sternberg (RS) cells. CONCLUSION: The two tumors are unique B-cell growths associated with separate clones of lymphocytes carrying episomal EBV. Patients with PTLD may be at risk for the continued development of EBV-associated disorders. Lymphomas resembling HD represent one possible manifestation of this risk.
M A Nalesnik; P Randhawa; A J Demetris; A Casavilla; J J Fung; J Locker
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Cancer     Volume:  72     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-11-10     Completed Date:  1993-11-10     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2568-73     Citation Subset:  AIM; IM    
Division of Transplantation Pathology, University of Pittsburgh School of Medicine, Pennsylvania.
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MeSH Terms
Blotting, Southern
Diagnosis, Differential
Herpesvirus 4, Human / isolation & purification*
Hodgkin Disease / diagnosis
Immunoenzyme Techniques
In Situ Hybridization
Liver Transplantation*
Lymphoma / diagnosis*,  etiology*,  immunology
Lymphoproliferative Disorders / etiology*,  immunology
Postoperative Complications*
Tumor Virus Infections / etiology*,  immunology
Grant Support
5PO1 CA 47445-02/CA/NCI NIH HHS

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