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Lymphoma mimics cytomegalovirus-induced hepatitis in a heart transplant recipient

G W Dec1, M J Semigran, G Vlahakes

  • 1Cardiac Transplant Program, Massachusetts General Hospital, Boston 02114.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|July 1, 1992
PubMed

Insights

A heart transplant recipient developed cytomegalovirus infection and a high-grade B-cell lymphoma. Despite ganciclovir treatment, the patient died from the lymphoma, highlighting post-transplant complications.

Area of Science:

  • Immunology
  • Oncology
  • Transplantation Medicine

Background:

  • Heart transplantation is a life-saving procedure for end-stage heart disease.
  • Immunosuppression post-transplantation increases the risk of opportunistic infections and malignancies.
  • Cytomegalovirus (CMV) is a common post-transplant complication.

Observation:

  • A 56-year-old diabetic male developed fever, thrombocytopenia, and hepatitis 8 weeks post-heart transplant.
  • Cytomegalovirus was detected in the patient's serum buffy coat.
  • The patient's condition worsened despite high-dose ganciclovir sodium therapy.

Findings:

  • Autopsy revealed an unsuspected high-grade B-cell lymphoma.
  • The lymphoma extensively infiltrated the liver.
  • The patient died on the seventy-seventh postoperative day.

Implications:

  • This case underscores the potential for aggressive post-transplant lymphoproliferative disorders.
  • CMV infection may coexist with or trigger lymphomagenesis in immunosuppressed individuals.
  • Early detection and management of both infections and malignancies are crucial in heart transplant recipients.

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