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Post-transplantation T cell lymphoblastic lymphoma.

S M Lippman, T M Grogan, P Carry

    The American Journal of Medicine
    |April 1, 1987
    PubMed
    Summary

    Post-transplantation lymphoma in immunosuppressed kidney transplant patients can present as a mediastinal mass. This case highlights a rare T-cell lymphoblastic lymphoma, questioning the typical Epstein-Barr virus link.

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    Area of Science:

    • Oncology
    • Transplantation Immunology
    • Virology

    Background:

    • Immunosuppression in renal transplant recipients increases lymphoma risk, typically B-cell phenotype.
    • Post-transplantation lymphoproliferative disorders (PTLD) are a significant concern in organ recipients.

    Observation:

    • A case of PTLD presented as a mediastinal mass causing superior vena cava syndrome, tracheal obstruction, and pleural effusion.
    • Pleural fluid analysis revealed high-grade lymphoblastic lymphoma with an immature T-cell phenotype (cortical thymocyte).

    Findings:

    • The lymphoma exhibited a T-cell lineage (Leu 1-6+, Leu 9+, Tdt+, B-, Calla+).
    • This T-cell phenotype is inconsistent with the commonly postulated Epstein-Barr virus (EBV) etiology for PTLD.

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    Implications:

    • This case challenges the conventional understanding of PTLD pathogenesis, particularly the role of EBV.
    • Further research is needed to understand the development of T-cell lymphomas in immunosuppressed transplant recipients.