Choi Jung-Hye, Ahn Myung-Ju, Oh Young-Ha, Han Sang-Woong, Kim Ho-Jung, Lee Young-Yeul, Kim In-Soon
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2006 Mar;21(1):46-9. doi: 10.3904/kjim.2006.21.1.46.
Post-transplant lymphoproliferative disorders (PTLD) have been recognized as a complication of immunosuppression and occur with a reported incidence of 1 to 8% of recipients receiving solid organ transplantation. PTLD are classified into two major categories, polymorphic and monomorphic PTLD. The majority of the monomorphic PTLD cases are non-Hodgkin's lymphoma of B-cell origin. Hodgkin's disease is not part of the typical spectrum of PTLD; however, it has been rarely reported. We describe a case of Hodgkin's disease following renal transplantation. A 41-year-old man developed right cervical lymphadenopathy following renal transplantation 116 months previously for chronic renal failure of unknown origin. He had been taking cyclosporine, mycophenolate mofetil and prednisone. A lymph node biopsy revealed mixed cellularity Hodgkin's disease. Immunohistochemical staining was positive for CD30 and EBV-latent membrane protein-1. No other site of disease was identified. The immunosuppressive agents were reduced (mycophenolate mofetil was discontinued, cyclosporine dose reduced from 200 mg to 150 mg and prednisone continued at 5 mg). After 2 cycles of ABVD followed by radiation therapy (3600 cGy), he achieved complete remission.
移植后淋巴组织增生性疾病（PTLD）已被确认为免疫抑制的一种并发症，据报道，在接受实体器官移植的受者中，其发生率为1%至8%。PTLD分为两大类，即多形性PTLD和单形性PTLD。大多数单形性PTLD病例为B细胞起源的非霍奇金淋巴瘤。霍奇金病不属于PTLD的典型范畴；然而，已有少数病例报道。我们描述一例肾移植后发生霍奇金病的病例。一名41岁男性在116个月前因不明原因的慢性肾衰竭接受肾移植，之后出现右侧颈部淋巴结病。他一直在服用环孢素、霉酚酸酯和泼尼松。淋巴结活检显示为混合细胞型霍奇金病。免疫组化染色CD30和EB病毒潜伏膜蛋白-1呈阳性。未发现其他疾病部位。免疫抑制剂减量（停用霉酚酸酯，环孢素剂量从200毫克减至150毫克，泼尼松继续维持在5毫克）。在接受2个周期的ABVD方案化疗后接着进行放射治疗（3600厘戈瑞），他实现了完全缓解。
