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Updated: May 24, 2026
Isolation and Quantification of Epstein-Barr Virus from the P3HR1 Cell Line
Published on: September 28, 2022
Molecular and clinicopathological analysis of Epstein-Barr virus-associated posttransplant smooth muscle tumors
Abstract:
Epstein-Barr virus (EBV)-associated posttransplant smooth muscle tumors (PTSMT) are very rare complications. We aimed to provide a clinicopathological characterization which is based on our own case series (n = 5) as well as previously reported PTSMT cases (n = 63). Meta-analysis of PTSMT and molecular analysis of tumor cells from our cohort was performed. Most PTSMT developed in kidney-transplanted patients (n = 41/68, 60%). Liver/transplant liver was the main site of manifestation (n = 38/68, 56%). Tumors occurred after a median interval of 48 months (range 5-348) and developed earlier in children than in adults. Most tumors showed no marked cellular atypia, low mitosis rate and no tumor necrosis. Gene expression analysis of 20 EBV-related genes, including two microRNAs, revealed overexpression of MYC (p = 0.0357). Therapy was mainly based on surgical resection or reduced immunosuppression but no significant differences in overall survival were evident. Lower overall survival was associated with multiorgan involvement (n = 33/68, 48.5%) and particularly with intracranial PTSMT manifestation (n = 7/68, 10%; p < 0.02), but not transplant involvement (n = 11/68, 16%). In summary, PTSMT differ from conventional leiomyosarcomas by their lack of marked atypia, unusual sites of involvement and defining EBV association. Surgery and reduced immunosuppression show comparable clinical results and prognosis is associated with intracranial manifestation.
Insights
Epstein-Barr virus-associated posttransplant smooth muscle tumors (PTSMT) are rare. These tumors, often in kidney transplant recipients, show distinct features and EBV association, with intracranial tumors impacting survival.
Area of Science:
- Oncology
- Transplantation Medicine
- Virology
Background:
- Epstein-Barr virus (EBV)-associated posttransplant smooth muscle tumors (PTSMT) are rare complications following organ transplantation.
- Understanding their clinicopathological features is crucial for diagnosis and management.
Purpose of the Study:
- To provide a comprehensive clinicopathological characterization of EBV-associated PTSMT.
- To analyze molecular features and survival outcomes in a larger cohort.
Main Methods:
- Meta-analysis of 68 reported PTSMT cases, including a series of 5 new cases.
- Molecular analysis of tumor cells focusing on EBV-related genes and microRNAs.
- Clinicopathological data review including tumor site, time to development, and survival.
Main Results:
- Most PTSMT occurred in kidney transplant recipients (60%) and liver transplant recipients (56%), typically developing 48 months post-transplant.
- Tumors exhibited low atypia and mitosis, with MYC gene overexpression identified.
- Lower overall survival was linked to multiorgan involvement and particularly intracranial PTSMT, not transplant involvement.
Conclusions:
- EBV-associated PTSMT are distinct from conventional leiomyosarcomas due to their EBV association, unusual sites, and lack of atypia.
- Surgical resection and reduced immunosuppression yielded comparable survival outcomes.
- Intracranial PTSMT manifestation is a significant negative prognostic factor.
