McFarlane R, Hurst S, Sabath D, George E, Argenyi Z
Department of Pathology, University of Washington School of Medicine, Seattle, WA 98195-6100, USA.
J Cutan Pathol. 2008 Jun;35(6):599-602. doi: 10.1111/j.1600-0560.2007.00864.x. Epub 2008 Jan 14.
Post-transplant lymphoproliferative disorder (PTLD) is a lymphoid proliferation that develops as a complication of solid organ or bone marrow transplants. Most cases usually present in the gastrointestinal tract, liver, kidney or lymph nodes. Plasmacytoma-like PTLD is an uncommon variant, and presentation in the skin is exceedingly rare. We present a case of plasmacytoma-like PTLD presenting as a leg mass in a 58-year-old male. Biopsy from the lesion exhibited atypical plasmacytoid and plasmablastic cells that showed lambda light chain restriction and stained positive for CD138 and Epstain-Bar virus early RNA by in situ hybridization. These findings were diagnostic of plasmacytoma-like PTLD. Only a few similar cases have been reported in the literature. The majority of these cases occurred in heart and kidney transplant patients. To our knowledge, this is the first reported case to occur in a lung transplant patient.
移植后淋巴细胞增生性疾病（PTLD）是一种作为实体器官或骨髓移植并发症而出现的淋巴样增生。大多数病例通常出现在胃肠道、肝脏、肾脏或淋巴结。浆细胞瘤样PTLD是一种罕见的变异型，在皮肤中出现极为罕见。我们报告一例58岁男性患者，其浆细胞瘤样PTLD表现为腿部肿块。病变活检显示非典型浆细胞样和浆母细胞，显示λ轻链限制，原位杂交检测CD138和爱泼斯坦-巴尔病毒早期RNA呈阳性。这些发现可诊断为浆细胞瘤样PTLD。文献中仅报道了少数类似病例。这些病例大多数发生在心脏和肾脏移植患者中。据我们所知，这是首次报道发生在肺移植患者中的病例。
