Hepatosplenic gammadelta-T-cell lymphoma with leukemic course after renal transplantation.

Abstract

Hepatosplenic gammadelta-T-cell lymphoma (HSTCL) is a rare extranodal T-cell non-Hodgkin's lymphoma (T-NHL) with only 46 well-documented cases in medical literature. Notably, a relatively high number of these case reports (15%) describe the occurrence of HSTCL after solid organ transplantation. We describe the case of a 45-year-old man who developed a leukemic HSTCL 5 years after renal transplantation and continous immunosuppression with cyclosporine A and prednisolone. After a rapid clinical course, the patient died and autopsy was performed. The malignant lymphocytes showed a natural killer-like gammadelta-T-cell phenotype (CD2(+), CD3(+), CD7(+), TCR gammadelta(+), CD56(+), TIA-1(+), CD4(-), CD8(-), and TCR alphabeta(-)) and infiltrated the sinusoids of liver and the red pulp of the spleen. Cytogenetically, an isochromosome 7q, trisomy 8, Y-loss, and a translocation t(1;4) was detectable. This case shows the difficulties of recognizing HSTCL early in the clinical course and underlines that all types of T-NHL, nodal as well as extranodal, have to be considered in the differential diagnosis of posttransplantation lymphoproliferative disorders. Moreover, HSTCL seems to occur as a specific late complication of solid organ transplantation.

• Authors: Michael Steurer, Reinhard Stauder, Kurt Grünewald, Eberhard Gunsilius, Hans-Christoph Duba, Guenther Gastl, Stephan Dirnhofer
• Journal: Human pathology (Hum Pathol) Vol. 33 Issue 2 Pg. 253-8 (Feb 2002) ISSN: 0046-8177 [Print] United States
• PMID: 11957154 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2002, Elsevier Science (USA). All rights reserved.

Chemical References

• Receptors, Antigen, T-Cell, gamma-delta

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cadaver
• Chromosomes, Human, Pair 7
• Fatal Outcome
• Flow Cytometry
• Humans
• Immunophenotyping
• Isochromosomes
• Karyotyping
• Kidney Transplantation (adverse effects)
• Leukemia-Lymphoma, Adult T-Cell (diagnosis, genetics, pathology)
• Liver Neoplasms (diagnosis, genetics, pathology)
• Lymphoma, T-Cell (diagnosis, genetics, pathology)
• Male
• Middle Aged
• Polymerase Chain Reaction
• Receptors, Antigen, T-Cell, gamma-delta (analysis)
• Splenic Neoplasms (diagnosis, genetics, pathology)