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Published on: May 10, 2017
Cutaneous presentation of plasmablastic post-transplant lymphoproliferative disorder in a 14-month-old
Claudia Hernandez1, Aaron S Cetner, Elizabeth L Wiley
1Department of Dermatology (MC 624), University of Illinois at Chicago, Chicago, Illinois 60612, USA. claudiah@uic.edu
Insights
A pediatric liver and small bowel transplant recipient developed skin nodules, diagnosed as high-grade post-transplant lymphoproliferative disorder (PTLD) consistent with plasmablastic lymphoma.
Area of Science:
- Oncology
- Pediatric Gastroenterology
- Transplantation Immunology
Background:
- Post-transplant lymphoproliferative disorder (PTLD) is a serious complication following solid organ transplantation.
- Early diagnosis and appropriate management are crucial for improving patient outcomes.
Observation:
- A 14-month-old female presented with multiple erythematous abdominal nodules 5 months post-liver and small bowel transplantation.
- Skin biopsy showed a dense infiltrate of large cells with high proliferation index (Ki67 >90%).
Findings:
- Immunohistochemistry revealed tumor cells positive for CD138, CD56, and lambda light chain restriction.
- The findings were consistent with high-grade PTLD, specifically plasmablastic lymphoma.
Implications:
- This case highlights the importance of considering PTLD in pediatric transplant recipients presenting with unusual skin lesions.
- Aggressive forms of PTLD, such as plasmablastic lymphoma, require prompt recognition and tailored therapeutic strategies.
Abstract:
We present a 14-month-old female child who developed multiple erythematous nodules on her abdomen 5 months after liver and small bowel transplantation. Skin biopsy revealed a dense infiltrate of large cells in the dermal and subcutaneous layers with frequent mitotic figures. The cells were noted to have abundant cytoplasm, prominent nucleoli, and open chromatin. Immunohistochemical stains were positive for CD138, CD56, Ki67 (>90%), and lambda chain restriction. Rare mature B cells (CD20) and rare T cells (CD3) were noted. She was diagnosed with high-grade post-transplant lymphoproliferative disorder most consistent with plasmablastic lymphoma.
