Zhang Yan-ning, Zhou Xiao-ge, Wang Cui-zhi, Wei Ping, Zhang Shu-hong, Zheng Yuan-yuan
Department of Pathology, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Zhonghua Bing Li Xue Za Zhi. 2006 Apr;35(4):209-12.
To study the clinical and pathologic features of post-transplant lymphoproliferative disorders (PTLD), and to investigate the clinical significance of this diagnosis.
Four cases of PTLD were studied by routine light microscopy, immunohistochemistry and in-situ hybridization and polymerase chain reaction. The clinical data and follow-up information were also reviewed.
In the 4 cases, 3 cases occurred in renal transplant recipients and 1 in bone marrow transplant patient. In the 3 post-renal transplant patients, 2 had polymorphic PTLD and 1 had monomorphic PTLD. The post-bone marrow transplant case was classified as "early" lesion of PTLD. Epstein-Barr virus (EBV) was detected in 2 cases. All the 4 cases studied had received cyclosporine A and steroids after transplantation. The duration between organ transplantation and diagnosis of PTLD from case 1 to case 4 was 42, 7, 129, 2 months. One of the polymorphic PTLD cases belonged to clinical stage II and subsequently died of the disease. Other cases belonged to clinical stage I and were alive for 5 to 40 months after diagnosis of PTLD.
PTLD is a lymphoproliferative disease with distinctive morphologic and clinical characteristics. An association with EBV at least in some cases is observed. The prognosis of PTLD correlates with clinical stage. It may respond to reduction in dosage of immunosuppressive agents.
研究移植后淋巴细胞增生性疾病（PTLD）的临床和病理特征，并探讨该诊断的临床意义。
通过常规光学显微镜、免疫组织化学、原位杂交及聚合酶链反应对4例PTLD进行研究。同时回顾临床资料及随访信息。
4例中，3例发生于肾移植受者，1例发生于骨髓移植患者。在3例肾移植后患者中，2例为多形性PTLD，1例为单形性PTLD。骨髓移植后病例被归类为PTLD的“早期”病变。2例检测到EB病毒（EBV）。所有4例研究对象移植后均接受了环孢素A和类固醇治疗。病例1至病例4从器官移植到诊断为PTLD的时间分别为42、7、129、2个月。其中1例多形性PTLD病例属于临床II期，随后死于该病。其他病例属于临床I期，诊断为PTLD后存活5至40个月。
PTLD是一种具有独特形态学和临床特征的淋巴细胞增生性疾病。至少在某些病例中观察到与EBV有关。PTLD的预后与临床分期相关。减少免疫抑制剂剂量可能有效。
