American Journal of Kidney Diseases
Volume 52, Issue 6 , Pages 1174-1179 , December 2008

Rejection Versus Posttransplantation Lymphoproliferative Disorder in a Renal Transplant Recipient

  • Megan L. Troxell, MD, PhD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • Corresponding Author InformationAddress correspondence to Megan L. Troxell, MD, PhD, Department of Pathology, L471, 3181 SW Sam Jackson Park Rd, Portland, OR 97239
    • ,
  • Jennifer B. Dunlap, MD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • ,
  • Anuja Mittalhenkle, MD

      Affiliations

    • Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • ,
  • Mona Ishag, MD

      Affiliations

    • Department of Pathology, Kaiser Permanente, Oregon Health & Science University, Portland, OR
    • ,
  • Guang Fan, MD, PhD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • ,
  • James Z. Huang, MD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • ,
  • Ken Gatter, JD, MD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR
    • ,
  • Dan M. Byrd, MD

      Affiliations

    • Department of Medicine, Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR
    • ,
  • Devon Webster, MD

      Affiliations

    • Department of Medicine, Division of Hematology and Medical Oncology, Oregon Health & Science University, Portland, OR
    • ,
  • Donald C. Houghton, MD

      Affiliations

    • Department of Pathology, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR

Received 28 January 2008 ,Accepted 22 April 2008.

References 

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  2. Tsao L, Hsi ED. The clinicopathologic spectrum of posttransplantation lymphoproliferative disorders. Arch Pathol Lab Med. 2007;131:1209–1218
  3. Shroff R, Rees L. The post-transplant lymphoproliferative disorder—A literature review. Pediatr Nephrol. 2004;19:369–377
  4. Randhawa PS, Magnone M, Jordan M, Shapiro R, Demetris AJ, Nalesnik M. Renal allograft involvement by Epstein-Barr virus associated post-transplant lymphoproliferative disease. Am J Surg Pathol. 1996;20:563–571
  5. Trpkov K, Marcussen N, Rayner D, Lam G, Solez K. Kidney allograft with a lymphocytic infiltrate: Acute rejection, posttransplantation lymphoproliferative disorder, neither, or both entities?. Am J Kidney Dis. 1997;30:449–454
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  9. Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol. 1999;17:3835–3849
  10. Blaes AH, Peterson BA, Bartlett N, Dunn DL, Morrison VA. Rituximab therapy is effective for posttransplant lymphoproliferative disorders after solid organ transplantation: Results of a phase II trial. Cancer. 2005;104:1661–1667
  11. Oertel SH, Verschuuren E, Reinke P, et al. Effect of anti-CD 20 antibody rituximab in patients with post-transplant lymphoproliferative disorder (PTLD). Am J Transplant. 2005;5:2901–2906
  12. Harris NL, Swerdlow SH, Frizzera G, Knowles DM. Post-transplantation lymphoproliferative disorder. In:  Jaffe ES,  Harris NL,  Stein H,  Vardiman JW editor. World Health Organization Classification of Tumours: Pathology and Genetics: Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC; 2001;p. 264–269
  13. Randhawa P, Demetris AJ, Pietrzak B, Nalesnik M. Histopathology of renal posttransplant lymphoproliferation: Comparison with rejection using the Banff schema. Am J Kidney Dis. 1996;28:578–584
  14. Vogler C, Wang Y, Brink DS, Wood E, Belsha C, Walker PD. Renal pathology in the pediatric transplant patient. Adv Anat Pathol. 2007;14:202–216
  15. Arias LF, Hernandez S, Prats D, et al. Epstein-Barr virus latency in kidney specimens from transplant recipients. Nephrol Dial Transplant. 2003;18:2638–2643
  16. Cosio FG, Nuovo M, Delgado L, et al. EBV kidney allograft infection: Possible relationship with a peri-graft localization of PTLD. Am J Transplant. 2004;4:116–123
  17. Frankel AH, Thompson M, Vulliamy T, et al. A T cell clone in association with an Epstein-Barr virus-related B cell lymphoma. Transplantation. 1991;52:1108–1109
  18. Euvrard S, Noble CP, Kanitakis J, et al. Brief report: Successive occurrence of T-cell and B-cell lymphomas after renal transplantation in a patient with multiple cutaneous squamous-cell carcinomas. N Engl J Med. 1992;327:1924–1926
  19. Nelson BP, Locker J, Nalesnik MA, Fung JJ, Swerdlow SH. Clonal and morphological variation in a posttransplant lymphoproliferative disorder: Evolution from clonal T-cell to clonal B-cell predominance. Hum Pathol. 1998;29:416–421
  20. Collins MH, Montone KT, Leahey AM, et al. Autopsy pathology of pediatric posttransplant lymphoproliferative disorder. Pediatrics. 2001;107:E89
  21. Koh BY, Rosenthal P, Medeiros LJ, et al. Posttransplantation lymphoproliferative disorders in pediatric patients undergoing liver transplantation. Arch Pathol Lab Med. 2001;125:337–343
  22. Chuhjo T, Yachie A, Kanegane H, Kimura H, Shiobara S, Nakao S. Epstein-Barr virus (EBV)-associated post-transplantation lymphoproliferative disorder simultaneously affecting both B and T cells after allogeneic bone marrow transplantation. Am J Hematol. 2003;72:255–258
  23. Yin CC, Medeiros LJ, Abruzzo LV, Jones D, Farhood AI, Thomazy VA. EBV-associated B- and T-cell posttransplant lymphoproliferative disorders following primary EBV infection in a kidney transplant recipient. Am J Clin Pathol. 2005;123:222–228
  24. Heyny-von Haussen R, Klingel K, Riegel W, Kandolf R, Mall G. Posttransplant lymphoproliferative disorder in a kidney-pancreas transplanted recipient: Simultaneous development of clonal lymphoid B-cell proliferation of host and donor origin. Am J Surg Pathol. 2006;30:900–905
  25. Preiksaitis JK. New developments in the diagnosis and management of posttransplantation lymphoproliferative disorders in solid organ transplant recipients. Clin Infect Dis. 2004;39:1016–1023
  26. Choquet S, Oertel S, LeBlond V, et al. Rituximab in the management of post-transplantation lymphoproliferative disorder after solid organ transplantation: Proceed with caution. Ann Hematol. 2007;86:599–607

 Originally published online as doi:10.1053/j.ajkd.2008.04.033 on August 13, 2008.

PII: S0272-6386(08)01004-4

doi: 10.1053/j.ajkd.2008.04.033

American Journal of Kidney Diseases
Volume 52, Issue 6 , Pages 1174-1179 , December 2008

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