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Epstein-Barr virus-associated T-cell lymphoma in a renal transplant patient.

Abstract
Posttransplant lymphoproliferative disorders in organ allograft recipients are most commonly of B cell origin, whereas T cell lymphomas are rarely described. We report a case of T cell immunoblastic large cell lymphoma associated with Epstein-Barr virus (EBV) that occurred in a recipient of a cadaveric renal transplant 7 years posttransplantation. On paraffin immunophenotyping, none of the neoplastic cells stained with the T cell-associated markers used, but did show strong CD30 expression. Flow cytometric studies revealed a predominance of T cells without definite evidence of T cell neoplasia. Frozen section immunophenotyping studies revealed a T cell phenotype with aberrant expression, and genotypic studies demonstrated T cell receptor beta gene rearrangement with germline configuration of immunoglobulin heavy chain and kappa light chain genes, confirming a T lineage. EBV-encoded RNA transcripts were demonstrated within the neoplastic cells by in situ hybridization. Southern blot analysis using probes derived from the terminal repeat region of the virus detected a single restriction band indicating a clonal population. We believe this is the first case of a posttransplant T cell lymphoma in which the EBV genome has been demonstrated. This case also illustrates the pitfalls of paraffin immunophenotyping in the diagnosis of T cell lymphoma.
AuthorsS Kumar, D Kumar, D W Kingma, E S Jaffe
JournalThe American journal of surgical pathology (Am J Surg Pathol) Vol. 17 Issue 10 Pg. 1046-53 (Oct 1993) ISSN: 0147-5185 [Print] United States
PMID8396856 (Publication Type: Case Reports, Journal Article)
Topics
  • Adult
  • Blotting, Southern
  • Herpesvirus 4, Human (isolation & purification)
  • Humans
  • Immunophenotyping
  • In Situ Hybridization
  • Kidney Transplantation (adverse effects)
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (etiology, immunology, pathology)
  • Transplantation Immunology
  • Tumor Virus Infections (etiology, immunology, pathology)

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