Document Detail


Recurrent Epstein-Barr virus-associated post-transplant lymphoproliferative disorder: report of a patient with histologically similar but clonally distinct metachronous abdominal and brain lesions.
MedLine Citation:
PMID:  10534178     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A liver transplant patient developed a single central nervous system (CNS) intraparenchymal lesion 5 months after the diagnosis of an intraabdominal diffuse large B-cell post-transplant lymphoproliferative disorder (PTLD). Biopsy of the new CNS lesion showed a diffuse large B-cell PTLD morphologically and immunohistochemically indistinguishable from the abdominal lesion. In addition, both lesions were positive for Epstein-Barr virus (EBV) DNA by polymerase chain reaction (PCR) and for EBV-encoded RNA by in situ hybridization. Although these results were consistent with a metastatic origin for the CNS lesion, the finding of an intraparenchymal lesion without leptomeningeal or dural spread was suggestive of a new primary CNS lymphoma. Proof that the brain lesion was a second primary and not a metastasis was obtained by immunoglobulin gene rearrangement studies and assessment of EBV clonality. Multiple primary lymphoid neoplasms arise at higher frequency in the setting of immunosuppression, and molecular investigations of tumor clonality can provide clinically relevant staging and prognostic information.
Authors:
J W Mandell; M L Gulley; M E Williams; M H Stoler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Human pathology     Volume:  30     ISSN:  0046-8177     ISO Abbreviation:  Hum. Pathol.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-02     Completed Date:  1999-11-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1262-5     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Neoplasms / pathology,  radiography,  virology
Adult
Brain Neoplasms / pathology,  virology
Clone Cells
DNA, Viral / isolation & purification
Epstein-Barr Virus Infections / diagnosis*
Fatal Outcome
Female
Humans
Immunohistochemistry
Liver Transplantation*
Lymphoproliferative Disorders / pathology,  virology*
Neoplasms, Second Primary / pathology,  radiography,  virology*
Postoperative Complications / virology*
RNA, Messenger / metabolism
RNA, Viral / isolation & purification,  metabolism
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/DNA, Viral; 0/Epstein-Barr virus encoded RNA 1; 0/RNA, Messenger; 0/RNA, Viral

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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