Epstein-Barr Virus-Associated Pulmonary Smooth Muscle Tumor After Lung Transplantation

Area of Science:

• Oncology
• Virology
• Transplantation Medicine

Background:

• Post-transplant smooth muscle tumors (PTSMTs) are rare complications following organ transplantation.
• Epstein-Barr virus (EBV) is known to be associated with various post-transplant lymphoproliferative disorders and other malignancies.
• Lung transplant recipients are at risk for developing de novo tumors.

Observation:

• A 71-year-old patient developed a smooth muscle tumor in the left lung allograft nearly 3 years after bilateral lung transplantation.
• The tumor was surgically resected using thoracoscopic wedge resection.
• Histopathologic examination revealed the tumor to be EBV-positive.

Findings:

• This case represents the first documented instance of an EBV-positive PTSMT occurring within the transplanted lung itself.
• Four previous cases of PTSMTs after lung transplantation have been reported, but none were EBV-positive and located within the allograft.
• The clinical, pathological, and histological features of this uncommon tumor are described.

Implications:

• This finding highlights the potential for EBV to drive the development of smooth muscle tumors in the allograft post-lung transplantation.
• Increased surveillance for EBV-associated malignancies in lung transplant recipients may be warranted.
• Understanding the pathogenesis of EBV-driven PTSMTs could lead to improved diagnostic and therapeutic strategies.