Epstein-Barr Virus-Associated Peripheral T-Cell Lymphoma involving Spleen in a Renal Transplant Patient

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Authors: Hye Kyung Lee ; Hee Jung Kim ; Woo-Ick Yang ; Chang Suk Kang ; Tae In Park ; Suk Young Kim ; Eun Hee Lee

MeSH: Granzymes ; Herpesvirus 4, Human/genetics ; Herpesvirus 4, Human/metabolism* ; Humans ; Ki-1 Antigen/genetics ; Ki-1 Antigen/metabolism ; Kidney Transplantation* ; Lymphoma, T-Cell, Peripheral/pathology ; Lymphoma, T-Cell, Peripheral/virology* ; Male ; Membrane Proteins/metabolism ; Middle Aged ; Poly(A)-Binding Proteins ; Proteins* ; RNA, Viral ; RNA-Binding Proteins/metabolism ; Serine Endopeptidases/metabolism ; Splenic Neoplasms/pathology ; Splenic Neoplasms/virology* ; T-Cell Intracellular Antigen-1

Keywords: Lymphoproliferative Disorders ; Lymphoma ; T-Cell : Spleen ; Herpesvirus 4, Human ; Antigens, CD30 ; Antigens, CD3

Abstract: The incidence of posttransplantation lymphoproliferative disorders (PTLDs) has increased in recent years. Although rare, various types of T-cell lymphoma have been reported and their association with Epstein-Barr virus (EBV) has been compared with B-cell PTLDs. We report a case of splenic peripheral T-cell lymphoma occurring in a 47-yr-old male patient 7 yr after renal allograft transplantation. The spleen showed sinusoidal proliferation of focal CD30 positive, large, atypical lymphoid cells. Positivity for CD3 and cytolytic granule-associated proteins was also demonstrated in the tumor cells, while anaplastic large cell lymphoma kinase (ALK) and CD8 were not expressed. Strong nuclear signals for EBV mRNA were noted by EBER1 in situ hybridization. A molecular genetic study demonstrated a rearrangement of the gamma T-cell receptor gene. To our knowledge, this case is unique in terms of a posttransplant T-cell lymphoma that shows focal CD30, cytolytic granule-associated proteins, and EBV positivity.