Case report: fatal lymphoproliferative disease seven weeks after liver transplantation

A 42-year-old man developed a lymphoproliferative disorder and died seven weeks after undergoing liver transplantation for primary biliary cirrhosis. At autopsy, diffuse large cell lymphoma was noted to involve almost every organ. Molecular analyses of DNA isolated from an enlarged periportal lymph node indicated the presence of Epstein-Barr virus sequences and several JH immunoglobulin gene rearrangements (consistent with the presence of more than one greatly expanded clone of lymphoid cells of B-cell lineage). This case underscores the possibility of the rapid emergence of lymphoproliferative disorder related to Epstein-Barr virus early after liver transplantation, masked by a concurrent episode of acute rejection.