Wirnsberger G H, Ratschek M, Dimai H P, Holzer H, Mandal A K
Department of Internal Medicine, Division of Nephrology, Karl-Franzens University, A-8036 Graz, Austria.
Oncol Rep. 1999 Jan-Feb;6(1):29-32. doi: 10.3892/or.6.1.29.
Marked impairment of the cellular immune system predisposes renal transplant recipients to Epstein-Barr virus (EBV) associated clinical syndromes. This can culminate in post-transplantation lymphoproliferative disorders (PTLD) and malignant lymphomas. An unusual PTLD in a 59-year-old renal transplant recipient is reported here. Sonography and CT scan revealed a hypovascular infiltrating tumor mass in the lower pole of the graft which on histopathologic examination revealed a monotonous lymphoid proliferation. T-cell receptor and immunoglobulin heavy chain gene rearrangement as well as immunohistochemical analyses demonstrated a polyclonal origin of atypical lymphatic T- and B-cells. The Epstein-Barr viral genome was detected in the mass by Southern blot analysis, and a primary EBV infection was confirmed by serologic studies. Clinical follow-up showed a tumor-free course till the patient's sudden cardiac death 14 months after the operation.
细胞免疫系统的显著损害使肾移植受者易患与 Epstein-Barr 病毒（EBV）相关的临床综合征。这可能最终导致移植后淋巴增殖性疾病（PTLD）和恶性淋巴瘤。本文报道了一名 59 岁肾移植受者发生的罕见 PTLD。超声检查和 CT 扫描显示移植肾下极有一个血供减少的浸润性肿瘤肿块，组织病理学检查显示为单一的淋巴细胞增殖。T 细胞受体和免疫球蛋白重链基因重排以及免疫组织化学分析表明非典型淋巴 T 细胞和 B 细胞起源于多克隆。通过 Southern 印迹分析在肿块中检测到 Epstein-Barr 病毒基因组，血清学研究证实为原发性 EBV 感染。临床随访显示，直到患者术后 14 个月突然心脏死亡，肿瘤未复发。
