Primary Cutaneous Polymorphic EBV-Associated Posttransplant Lymphoproliferative Disorder After a Renal Transplant and Review of the Literature

The American Journal of Dermatopathology
Nkanyezi N FergusonKarolyn A Wanat

Abstract

Posttransplant lymphoproliferative disorder (PTLD) is an uncommon complication after solid organ transplants and hematopoietic stem cell transplants. Extranodal involvement in PTLD can involve several organ systems, including the central nervous system, bone marrow, lungs, gastrointestinal tract, and skin. Isolated involvement of the skin without systemic involvement in PTLD is rare. Primary cutaneous PTLD is generally categorized as either cutaneous T-cell lymphomas or cutaneous B-cell lymphomas, with variable Epstein-Barr virus (EBV) positivity. Herein, we describe an exceedingly uncommon case of a polymorphic variant of primary cutaneous PTLD. A woman in her 30s, who received an EBV+ deceased donor kidney transplant, presented with a 2-week history of 2 indurated patches over the lower abdomen. A skin biopsy revealed an atypical lymphoid proliferation with immunohistochemical stains demonstrating a mixed population of both B and T cells that stained strongly positive for EBV-encoded RNA. A bone marrow biopsy and positron emission tomography/computed tomography were negative for systemic involvement. The patient was treated with immunosuppression reduction and rituximab infusions. This case highlights a rare polymorphic varia...Continue Reading

References

Oct 1, 1993·Journal of the American Academy of Dermatology·J M McGregorD M MacDonald
Jul 17, 1999·Journal of Cutaneous Pathology·C ChaiV G Prieto
Mar 7, 2003·Bone Marrow Transplantation·A W LorenD E Tsai
Nov 4, 2004·Journal of the American Academy of Dermatology·Laura CapaldiReginald Gohh
Nov 24, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S H K OertelH B Riess
Mar 8, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Thomas Fehr, Ariana Gaspert
May 31, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D SeçkinG F L Hofbauer
Jun 6, 2013·Current Hematologic Malignancy Reports·Zeina Al-MansourAndrew M Evens

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Citations

Jan 24, 2019·Journal of Cutaneous Pathology·Carly DunnHarry Dao
Nov 21, 2020·Clinical Transplantation·Maria Carolina Corsi FerreiraAdriana Maria Porro
Apr 27, 2021·The American Journal of Dermatopathology·Ashley P CraddockShyam S Raghavan

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