Related Experiment Videos
Posttransplant CD30+ anaplastic large cell lymphoma with skin and lymph node involvement
H Yurtsever1, W Kempf, R H Laeng
1Department of Pathology, Kantonsspital Aarau, Aarau, Switzerland.
Dermatology (Basel, Switzerland)
|July 2, 2003
Summary
This study details a rare case of CD30-positive T-cell posttransplant lymphoproliferative disorder (PTLD) in a kidney transplant recipient. The aggressive lymphoma presented uniquely, lacking common viral markers and showing an incomplete T-cell immunophenotype.
Area of Science:
- Oncology
- Immunology
- Transplantation Medicine
Background:
- Posttransplant lymphoproliferative disorders (PTLD) are common complications following organ transplantation.
- Most PTLD cases are B-cell in origin, making CD30-positive T-cell PTLD exceptionally rare.
Observation:
- A 59-year-old male kidney transplant recipient presented with a CD30-positive anaplastic large cell lymphoma (ALCL) affecting the skin and lymph nodes.
- The tumor exhibited an incomplete T-cell immunophenotype and a rearranged T-cell receptor gamma gene, indicating T-cell lineage.
- Epstein-Barr virus and human herpesvirus 8 were notably absent in the neoplastic cells.
Findings:
- The anaplastic lymphoma kinase (ALK)-1 protein was not expressed by the neoplastic cells.
- Immunoreactivity to epithelial membrane antigen and systemic presentation argued against a primary cutaneous anaplastic large cell lymphoma.
- This rare posttransplantation systemic ALCL demonstrated aggressive behavior with a poor response to standard treatments.
Implications:
- This case expands the understanding of rare T-cell PTLD subtypes and their clinical presentation.
- Highlights the importance of thorough immunophenotypic and genotypic analysis in diagnosing PTLD in transplant recipients.
- Suggests that ALK-negative and EBV/HHV-8 negative PTLD may require alternative therapeutic strategies.