Post-transplant malignant lymphoma with monoclonal immunoglobulin gene rearrangement and polyclonal Epstein-Barr virus episomes

J Clin Pathol. 2001 Nov;54(11):887-9. doi: 10.1136/jcp.54.11.887.

Abstract

This report describes the case of an 8 year old boy who developed ileocecal B cell lymphoma after liver transplantation. The patient underwent orthotopic liver transplantation for biliary atresia and had been given immunosuppressive drugs--cyclosporin A and tacrolimus hydrate. Six years after the liver transplantation, the patient had a sudden onset of fever and abdominal pain. Necropsy revealed an ileocecal mass that was a B cell lymphoma. Epstein-Barr virus (EBV) encoded RNA 1 was demonstrated in lymphoma cells and hyperplastic follicular germinal centre cells in various tissues. Although monoclonal immunoglobulin gene rearrangement was detected in the liver, EBV episomes were of polyclonal origin and lytic forms of EBV were also demonstrated by Southern blotting. Immunohistochemically, lymphoma cells were positive for p53 but negative for latent membrane protein 1 and EBV nuclear antigen 2. These findings suggested that this B cell lymphoma might have occurred sporadically, regardless of EBV infection.

Publication types

  • Case Reports

MeSH terms

  • Biliary Atresia / genetics
  • Biliary Atresia / pathology
  • Biliary Atresia / surgery
  • Cecal Neoplasms / genetics
  • Cecal Neoplasms / pathology*
  • Child
  • Fatal Outcome
  • Gene Rearrangement, B-Lymphocyte
  • Genes, Immunoglobulin
  • Herpesvirus 4, Human / genetics
  • Humans
  • Ileal Neoplasms / genetics
  • Ileal Neoplasms / pathology*
  • Immunohistochemistry
  • Liver Neoplasms / genetics
  • Liver Neoplasms / pathology*
  • Liver Transplantation*
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / pathology*
  • Male
  • Polymerase Chain Reaction
  • Postoperative Complications / pathology*
  • RNA, Viral / analysis
  • Tumor Suppressor Protein p53 / analysis

Substances

  • RNA, Viral
  • Tumor Suppressor Protein p53