Strazzabosco M, Corneo B, Iemmolo R M, Menin C, Gerunda G, Bonaldi L, Merenda R, Neri D, Poletti A, Montagna M, Del Mistro A, Faccioli A M, D'Andrea E
Institute of Internal Medicine, University of Padova and Azienda Ospedaliera di Padova, Padua, Italy.
J Hepatol. 1997 Apr;26(4):926-34. doi: 10.1016/s0168-8278(97)80262-0.
BACKGROUND/AIMS: Post-transplant lymphoproliferative disease, a potential complication of solid organ transplantation, occurs in about 3% of orthotopic liver transplant recipients. We report the genetic and virological characterization of two cases of post-transplant lymphoproliferative disease that occurred early (4 and 6 months) after orthotopic liver transplant as large-cell non-Hodgkin's lymphomas located at the hepatic hilum.
Lymphomatous tissues were analyzed for clonality and presence of Epstein-Barr virus (EBV) sequences by Southern blot, polymerase chain reaction, and in situ hybridization techniques.
The tumors in both cases were sustained by a clonal proliferation of B lymphocytes containing type A EBV DNA. Moreover, in situ hybridization with a digoxigenin-labeled EBV-specific probe evidenced a strong nuclear signal in most of the neoplastic cells. DNA microsatellite analysis at three different loci detected alleles of donor origin in both tumor samples, suggesting that the neoplastic B cells were of donor origin.
EBV-infected donor B lymphocytes might be responsible for intragraft post-transplant lymphoproliferative disease in orthotopic liver transplant recipients. As 20 to 30% of post-transplant lymphomas involve the graft itself, donor-derived post-transplant lymphoproliferative disease might be more frequent than presently appreciated. Prospective studies are needed to assess its real incidence and identify possible risk factors.
背景/目的：移植后淋巴细胞增生性疾病是实体器官移植的一种潜在并发症，约3%的原位肝移植受者会发生。我们报告了两例原位肝移植后早期（4个月和6个月）发生的移植后淋巴细胞增生性疾病的遗传学和病毒学特征，这两例均为位于肝门的大细胞非霍奇金淋巴瘤。
通过Southern印迹法、聚合酶链反应和原位杂交技术分析淋巴瘤组织的克隆性及EB病毒（EBV）序列的存在情况。
两例肿瘤均由含有A型EBV DNA的B淋巴细胞克隆性增殖所致。此外，用地高辛标记的EBV特异性探针进行原位杂交显示，大多数肿瘤细胞中有强烈的核信号。在三个不同位点进行的DNA微卫星分析在两个肿瘤样本中均检测到供体来源的等位基因，提示肿瘤性B细胞来源于供体。
EBV感染的供体B淋巴细胞可能是原位肝移植受者移植后移植物内淋巴细胞增生性疾病的病因。由于20%至30%的移植后淋巴瘤累及移植物本身，供体来源的移植后淋巴细胞增生性疾病可能比目前认识到的更为常见。需要进行前瞻性研究以评估其实际发病率并确定可能的危险因素。
