T-cell posttransplant lymphoproliferative disorder occurring in a pediatric solid-organ transplant patient

The American Journal of Surgical Pathology
Ryan LundellMegan S Lim

Abstract

Posttransplantation lymphoproliferative disorder (PTLD) is a serious complication seen in transplant patients as a consequence of immunosuppressant therapy. Most cases are of B-cell origin and are commonly associated with Epstein-Barr virus (EBV) infection. T-cell PTLDs are rare and only 13 pediatric T-cell PTLDs with clinicopathologic correlation have been reported previously. We present the histologic, immunophenotypic, and molecular features of a monomorphic PTLD (T-cell lymphoma) identified in a pediatric patient following orthotopic liver transplantation. The lymphoma was identified in the ileum, rectum, and mesenteric lymph nodes. In situ hybridization revealed numerous EBER-1-positive tumor cells. A current review of the literature is also discussed. Of the 14 cases of pediatric T-cell PTLD reported in the literature, only 3 (21.4%) are described as being EBV positive. Most of the reported PTLDs are monoclonal, with 9 of 11 cases (82%) showing a clonal T-cell population by gene rearrangement studies. T-cell PTLD cases appear to have a poor prognosis (11 of 14 patients died of the disease), although patients with involvement of specific anatomic sites may have a better outcome.

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Citations

Aug 12, 2009·International Journal of Hematology·Hideaki OhtaKeiichi Ozono
Nov 18, 2008·Journal of Pediatric Hematology/oncology·Sandip BartakkeSheila Weitzman
May 19, 2007·American Journal of Clinical Pathology·Steven H Swerdlow
Oct 31, 2006·Surgical Neurology·I-Chang SuChang-Mu Chen
Sep 18, 2008·Pediatric Transplantation·Tamir MilohDeepa Bhojwani
Mar 30, 2010·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Q-F LiuY-Q Ding
Sep 26, 2006·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Alison J BruceLuis A Castro
Mar 5, 2013·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Benedicta E Beck-BroichsitterStephan T Becker
Feb 15, 2016·Journal of Pharmaceutical and Biomedical Analysis·Adriana Mika, Piotr Stepnowski
Jul 7, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Vera GrauteMarcus Hacker
Aug 9, 2011·Bone Marrow Transplantation·T SchechterJ Doyle
Feb 24, 2007·Pediatric Blood & Cancer·Kirsten M WilliamsRobert J Arceci

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