Burkitt’s lymphoma variant of post-transplant lymphoproliferative disease (PTLD)

Springer Science and Business Media LLC - Tập 8 - Trang 105-108 - 2002
Melissa A. Pasquale1, Debbie Weppler2, Jon Smith1, Michael Icardi1, Alexandra Amador1, Monica Gonzalez2, Tomoaki Kato2, Andreas Tzakis2, Phillip Ruiz1,2
1Department of Pathology, University of Miami School of Medicine, Jackson Memorial Hospital - Holtz Center, Miami
2Department of Surgery, University of Miami, Miami, USA

Tóm tắt

The occurrence of posttransplant lymphoproliferative disorder (PTLD) in solid organ allograft recipients can be quite varied in clinical presentation, histopathological characteristics and frequency. A variety of lymphomas can develop as a PTLD although some types appear infrequently and remain poorly understood in this clinical setting. In this report, we describe two cases of Burkitt’s lymphoma presenting as a PTLD following liver transplantation. The recipients were 12 and 44 years of age and displayed gastrointestinal involvement by the tumors several years following transplant. The tumors displayed the typical histological features of Burkitt’s lymphoma and were markedly positive for EBV. The tumors displayed similar immunophenotypic characteristics by flow cytometry and had rearrangements of the immunoglobulin J-H heavy chain. The tumors required aggressive chemotherapy and a cessation of immunosuppressive therapy. This report demonstrates that Burkitt’s type lymphomas can develop in the posttransplant setting and that these tumors contain morphologic, cytofluorographic and molecular features identical to Burkitt’s lymphomas that occur in non-transplant patients. Our experience is that these PTLD-Burkitt’s lymphomas behave aggressively and require intensive chemotherapeutic intervention.

Tài liệu tham khảo

Jain A, Reyes J, Kashyap R, et al: Liver transplantation under tacrolimus in infants, children, adults and seniors: long-term results, survival and adverse events in 1000 consecutive patients. Transplant Proc 30:1403–1404, 1998. Ho M, Jaffe R, Miller G, et al: The frequency of Epstein-Barr virus infection and associated lymphoproliferative syndrome after transplantation and its manifestations in children. Transplantation 45:719–727, 1988. Cacciarelli TV, Green M, Jaffe R, et al: Management of posttransplant lymphoproliferative disease in pediatric liver transplant recipients receiving primary tacrolimus (FK506) therapy. Transplantation 66:1047–1052, 1998. Malatack JF, Gartner JC Jr, Urbach AH, Zitelli BJ: Orthotopic liver transplantation, Epstein-Barr virus, cyclosporine, and lymphoproliferative disease: a growing concern. J Pediatr 118:667–675, 1991. Harris NL, Ferry JA, Swerdlow SH: Posttransplant lymphoproliferative disorders: summary of Society for Hematopathology Workshop. Semin Diag Pathol 1997; 14(1):8–14. Penn I. Cancers complicating organ transplantation. NEJM 323:1767–1769, 1990. Leblond V, Sutton L, Dorent R, et al: Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center. J Clin Oncol 13:961–968, 1995. Frank D, Cesarman E, Lie YF, et al: Posttransplantation lymphoproliferative disorders frequently contain Type A and not Type B Epstein-Barr virus. Blood 85:1396–1403, 1995. Walker RC, Paya, CV, Marshall WF, et al: Pretransplantation seronegative Epstein-Barr virus status is the primary risk factor for posttransplantation lymphoproliferative disorder in adult heart, lung, and othe rsolid organ transplantations. J Heart Lung Transplant 14:214–221, 1995. Harris NL, Jaffe ES, Diebold J, et al: World Health Organization classification of neoplastic diseases of the haematopoietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting, Airlie House, Virginia, November 1997. Histopathology 36:69–86, 2000. Berard, et al. Histopathological definition of Burkitt’s Tumour. Bull WHO 40:601–607, 1969. Cossman J, Uppenkamp M, Sundeen J, et al: Molecular genetics and the diagnosis of lymphoma. Arch Pathol Lab Med 112:117–127, 1988. Wu TC, Mann RB, Epstein JI, et al: Abundant expression of EBER1 am 11 nuclear RNA in nasopharyngeal carcinoma, a morphologically distinctive target for detection of Epstein-Barr virus in formalin-fixed paraffin-embedded carcinoma specimens. Am J Pathol 46:1310–1313, 1991. Rea D, Fourcade C, Leblond V, et al: Epstein-Barr virus latent and replicative gene expression in posttransplant lymphoproliferative disorders and AIDS-related non-Hodgkin’s lymphomas. Ann Oncol 5 (Suppl 1): S113-S116, 1994. Cen H, Williams PA, McWilliams HP, et al: Evidence of restricted Epstein-Barr virus latent gene expression and anti-EBNA antibody response in solid organ transplant recipients with posttransplant lymphoproliferative disorders. Blood 81:1393–1403, 1993. Smets F, Vajro P, Cornu G, et al: Indications and results of chemotherapy in children with posttransplant lymphoproliferative disease after liver transplantation. Transplantation 69:982–984, 2000.