Somers G R, Tesoriero A A, Hartland E, Robertson C F, Robinson P J, Venter D J, Chow C W
Department of Pathology, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia.
Am J Surg Pathol. 1998 Nov;22(11):1423-8. doi: 10.1097/00000478-199811000-00014.
The occurrence of Epstein-Barr virus-associated smooth-muscle tumors in immunocompromised patients has been reported, particularly in the pediatric population. In posttransplantation tumors, the tissue of origin has been either donor or recipient. Mixed-genotype sarcomas within the same patient have not yet been reported. We describe the occurrence of multiple leiomyosarcomas of both donor (arising in the lung allograft) and recipient (arising in the host liver) origin in a 15-year-old boy 3 years after heart-lung transplantation. Analysis of premortem lung tumors demonstrated the presence of Epstein-Barr virus DNA. Despite decreasing immunosuppression and commencing acyclovir, the patient died of systemic Pseudomonas infection. Immunohistochemical analysis revealed that both lung and liver tumors were negative for the Epstein-Barr virus receptor (CD21), and suggests that Epstein-Barr virus entry into the cells was not via this receptor but via an alternate mechanism such as cell fusion.
免疫功能低下患者中与爱泼斯坦-巴尔病毒相关的平滑肌肿瘤的发生已有报道，尤其是在儿童人群中。在移植后肿瘤中，肿瘤起源组织可能是供体或受体。同一患者体内混合基因型肉瘤尚未见报道。我们描述了一名15岁男孩在心肺移植3年后发生的多例分别起源于供体（肺移植组织）和受体（宿主肝脏）的平滑肌肉瘤。对生前肺部肿瘤的分析显示存在爱泼斯坦-巴尔病毒DNA。尽管免疫抑制逐渐减少并开始使用阿昔洛韦，但患者死于全身性铜绿假单胞菌感染。免疫组织化学分析显示，肺部和肝脏肿瘤的爱泼斯坦-巴尔病毒受体（CD21）均为阴性，这表明爱泼斯坦-巴尔病毒进入细胞并非通过该受体，而是通过诸如细胞融合等其他机制。
