Faculty Collaboration Database

Primary Cutaneous Polymorphic EBV-Associated Posttransplant Lymphoproliferative Disorder After a Renal Transplant and Review of the Literature. Am J Dermatopathol 2015 Oct;37(10):790-4

Date

03/10/2015

Pubmed ID

25747810

DOI

10.1097/DAD.0000000000000272

Scopus ID

2-s2.0-84941962051 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

IMPORTANCE: Posttransplant lymphoproliferative disorder (PTLD) is an uncommon complication after solid organ transplants and hematopoietic stem cell transplants. Extranodal involvement in PTLD can involve several organ systems, including the central nervous system, bone marrow, lungs, gastrointestinal tract, and skin. Isolated involvement of the skin without systemic involvement in PTLD is rare. Primary cutaneous PTLD is generally categorized as either cutaneous T-cell lymphomas or cutaneous B-cell lymphomas, with variable Epstein-Barr virus (EBV) positivity. Herein, we describe an exceedingly uncommon case of a polymorphic variant of primary cutaneous PTLD.

OBSERVATIONS: A woman in her 30s, who received an EBV+ deceased donor kidney transplant, presented with a 2-week history of 2 indurated patches over the lower abdomen. A skin biopsy revealed an atypical lymphoid proliferation with immunohistochemical stains demonstrating a mixed population of both B and T cells that stained strongly positive for EBV-encoded RNA. A bone marrow biopsy and positron emission tomography/computed tomography were negative for systemic involvement. The patient was treated with immunosuppression reduction and rituximab infusions.

CONCLUSIONS AND RELEVANCE: This case highlights a rare polymorphic variant of primary cutaneous EBV-associated PTLD and increases awareness of this uncommon posttransplant complication. Cutaneous PTLD is reviewed, therefore dermatologists are aware of this uncommon disorder.

Author List

Ferguson NN, Thomas CP, Hohl RJ, Syrbu SI, Stone MS, Wanat KA

Author

Karolyn A. Wanat MD Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Biopsy
Epstein-Barr Virus Infections
Female
Herpesvirus 4, Human
Humans
Immunohistochemistry
Immunologic Factors
Immunosuppressive Agents
Kidney Transplantation
Lymphoproliferative Disorders
Positron-Emission Tomography
Rituximab
Skin Diseases, Viral
Tomography, X-Ray Computed
Treatment Outcome