Uribe-Uribe N O, Avilés-Salas A, Orozco-Estévez H, Alberú J, Angeles-Angeles A
Departamento de Patología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Rev Invest Clin. 1998 May-Jun;50(3):255-8.
Recently the association between the Epstein-Barr virus (EBV) and smooth muscle lesions has been described in immunosuppressed children but it is infrequent in adults. The role of EBV in the pathogenesis of these lesions is obscure. We presents a 28 year old man with end stage renal disease transplanted in 1994. Two years later he developed several nodular lesions that affected both lungs, liver, spleen, retroperitoneal ganglia and the left thigh; one year later he died. The surgical specimen from the thigh and a liver biopsy were diagnosed as leiomyosarcoma. Immunohistochemical reactions against vimentin and smooth muscle actin were positive. In situ hybridization disclosed positivity against EBV nuclear antigens (EBNA-2) in neoplasic cells. This is the first case of sarcoma in transplanted patients of our institution and represents a rare case of leiomyosarcoma associated with EBV in adults.
最近,在免疫抑制儿童中已描述了爱泼斯坦-巴尔病毒(EBV)与平滑肌病变之间的关联,但在成人中并不常见。EBV在这些病变发病机制中的作用尚不清楚。我们报告一名1994年接受终末期肾病移植的28岁男性。两年后,他出现了多个结节性病变,累及双肺、肝脏、脾脏、腹膜后神经节和左大腿;一年后他去世。大腿手术标本和肝脏活检被诊断为平滑肌肉瘤。针对波形蛋白和平滑肌肌动蛋白的免疫组化反应呈阳性。原位杂交显示肿瘤细胞中存在针对EBV核抗原(EBNA-2)的阳性反应。这是我们机构移植患者中首例肉瘤病例,代表了成人中罕见的与EBV相关的平滑肌肉瘤病例。