Lymphoma and plasma cell neoplasms
Posttransplantation
Other

Author: Nat Pernick, M.D. (see Authors page)

Revised: 17 March 2017, last major update September 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Posttransplantation lymphoproliferative disorders Other

Cite this page: Post-transplant lymphoproliferative disorders. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphomanonBposttransother.html. Accessed November 22nd, 2017.
Posttransplant anaplastic large cell lymphoma

Case reports:

Micro images:

Images hosted on other servers:

Gastric tumor post heart / liver transplant


Posttransplant Burkitt lymphoma

Clinical features:
  • 5 cases reported (4 men, 1 woman, mean 35 years old, Am J Surg Pathol 2003;27:818)
  • Interval averaged 4.5 years
  • Presents with high stage disease with generalized lymphadenopathy and bone marrow involvement


Treatment:
  • Rituximab or combination chemotherapy led to complete remission


Micro description:
  • Burkitt or Burkitt-like morphology with monomorphic intermediate sized tumor cells with a small rim of basophilic cytoplasm, round nuclei and multiple small nuclei, also many tingible body macrophages giving a typical starry sky pattern
  • Touch preparations show deeply basophilic cytoplasm with numerous vacuoles
  • Atypical (Burkitt-like) cases have more variability in size and shape


Micro description:
  • C-Myc rearrangement, EBV

Posttransplant diffuse large B cell lymphoma

Clinical features:
  • Common histologic type of posttransplant monomorphic lymphoma


Case reports:

Micro images:

Images hosted on other servers:

1: CT with multiple liver lesions;
2: diffuse liver involvement by large cells with prominent nucleoli;
3: CD20+;
4: EBV+; pleomorphic atypical lymphoid cells; CD20+


Posttransplant histiocytic sarcoma

Micro images:

Images hosted on other servers:

Cells with large, irregular nuclei (figure 3)



Positive stains:
Posttransplant Hodgkin lymphoma

Clinical features:
  • Uncommon type of PTLD
  • Most often post renal transplantation
  • Almost always EBV+
  • CD30+, CD15+ (CD15- cases may exist), CD45-, CD20-
  • Rare cases may follow other types of PTLD


Micro description:
  • Plasma cells, lymphocytes and eosinophils mixed with Reed-Sternberg or similar appearing cells


Positive stains:

Negative stains:

Molecular description:
  • No immunoglobulin gene rearrangements

Posttransplant Hodgkin lymphoma-like lymphoproliferative disorder

Description:
  • Very rare
  • Cases to date involve males, often teenagers
  • Similar to Hodgkin lymphoma, but with atypical phenotype
  • Nodal or extranodal
  • Appears to be a type of B cell posttransplant lymphoproliferative disorder (Arch Pathol Lab Med 2006;130:558)


Treatment:
  • Reduce immunosuppression, variable chemotherapy or radiation therapy


Micro description:
  • Small to medium lymphoid cells mixed with Reed-Sternberg like cells (large, mono, bi or multinucleated); also histiocytes, plasma cells and rare eosinophils


Micro images:

Images hosted on other servers:

Reed-Sternberg like-cells are CD30+



Positive stains:
  • Reed-Sternberg-like cells: CD45, CD20, CD79a, EBER; variable CD30; lymphoid cells are B / T cells and often EBER+


Negative stains:

Molecular description:
  • Immunoglobulin gene rearrangements

Posttransplant MALT-type extranodal marginal zone lymphomas

Clinical features:
  • Rare, 5 cases reported at Am J Surg Pathol 2000;24:100
  • Mean age 51 years (range, 48 - 63 years); after heart, liver, kidney transplants; involves stomach (H. pylori+) and parotid gland
  • Occurs average 7 years posttransplant
  • All tumors reported above were low-grade MALT, EBV negative, nonaggressive

Posttransplant myeloma

Clinical features:

Micro images:

Images hosted on other servers:

Various images


Posttransplant NK/T cell lymphoproliferative disorders

Clinical features:
  • Rare, < 100 cases reported; most posttransplant lymphoproliferative disorders are B cell origin
  • 20% are associated with Epstein Barr virus


Case reports of extranodal NK/T cell lymphoma, nasal-type:

Micro description:
  • Angiocentric growth of medium to large lymphoid cells with necrosis


Micro images:

Images hosted on other servers:

Breast tumor after heart transplant


Post-transplant T cell lymphoma of bone marrow

Case reports:

Micro description:
  • Focal or extensive interstitial involvement of large cells with abundant cytoplasm and prominent nucleoli
  • Cellular debris is prominent
  • Reduced normal hematopoiesis
  • May be difficult to identify without special stains


Positive stains: