Persistent Epstein-Barr virus infection and a histiocytic sarcoma in a renal transplant recipient

Lymphomas occurring in renal transplant recipients are mostly large cell non-Hodgkin's lymphomas (B-cell-derived). A sarcoma with all morphologic, immunohistochemical, and ultrastructural characteristics of a tumor of the mononuclear phagocytic system (MPS) developed in a 23-year-old woman 1 year after renal transplantation. Anti-Epstein-Barr-virus antibody titers proved to be exceptionally high, even in pretransplant sera. Tumor-derived cells proved to be positive for Epstein-Barr nuclear antigen (EBNA), and hybridization showed multiple copies of Epstein-Barr virus (EBV)-DNA, suggesting a relationship between this tumor and EBV. More widespread use of immunochemical and histochemical diagnostic techniques might detect more cases, which, until now, have probably been diagnosed as B-cell-derived immunoblastic lymphomas.