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Bejarano L, Sayagués JM, Alcoceba M, Balanzategui A, Lopez-Corral L, Cañueto J, Santos-Briz A. Primary Cutaneous Marginal Zone Lymphoproliferative Disorder of Donor Origin after Allogeneic Hematopoietic Stem Cell Transplantation. Am J Dermatopathol 2023; 45:378-382. [PMID: 37130208 DOI: 10.1097/dad.0000000000002439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
ABSTRACT Primary cutaneous posttransplant lymphoproliferative disorders (PTLDs) after allogeneic hematopoietic stem cell transplant (allo-HSCT) are exceedingly rare, with only 6 published cases, all of them consisting in T-cell neoplasms. In this report, we present for the first time a donor-derived B-cell PTLD consisting in a primary, cutaneous, B-cell, marginal zone, lymphoproliferative disorder (PCMZLPD). The patient, a 37-year-old woman with a history of Hodgkin lymphoma received an allo-HSCT from her healthy, matched, related father, achieving complete host chimerism in the bone marrow and peripheral blood. However, 8 years after the allo-HSCT, she presented asymptomatic skin lesions consisting in oval, well-defined, slightly raised erythematous plaques, located on the arms, trunk, and legs. Skin biopsies of 2 lesions demonstrated a class-switched IgG+, EBV-, PCMZLPD, showing kappa light chain restriction and monoclonal rearrangement of the IgH gene. Microsatellite genotyping and 2-color fluorescence in situ hybridization (X and Y chromosomes) confirmed that the origin of the neoplastic cells was the donor graft. The lesions showed an indolent behavior, good response to topical corticosteroids, and no need for systemic treatment. Our case broadens the spectrum of PTLD, a diverse group of lymphoid and/or plasmacytic proliferations with variable clinical presentations and histopathological features.
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Affiliation(s)
- Lía Bejarano
- Service of Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Jose María Sayagués
- Department of Pathology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
| | - Miguel Alcoceba
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Ana Balanzategui
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Lucia Lopez-Corral
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
- Department of Haematology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain; and
- Cancer Research Centre-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Javier Cañueto
- Service of Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
| | - Angel Santos-Briz
- Department of Pathology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Institute for Biomedical Research (IBSAL), Salamanca, Spain
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Santos-Briz A, Romo A, Antúnez P, Román C, Alcoceba M, Garcia JL, Vazquez L, González M, Unamuno P. Primary cutaneous T-cell lymphoproliferative disorder of donor origin after allogeneic haematopoietic stem-cell transplantation. Clin Exp Dermatol 2009; 34:e778-81. [PMID: 19817764 DOI: 10.1111/j.1365-2230.2009.03509.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 56-year-old male patient had a history of mantle-cell lymphoma, which was treated with polychemotherapy and reduced-intensity conditioning allogeneic haematopoietic stem cell transplantation (ASCT) from his healthy sister with an identical human leucocyte antigen profile. Six years after transplantation, the patient developed asymptomatic eczema-like cutaneous lesions. Histologically the lesions contained a dense superficial lichenoid infiltrate, mainly consisting of CD4+ atypical medium to large lymphocytes showing indented hyperchromatic nuclei. In situ hybridization for Epstein-Barr virus was negative. PCR amplification of the T-cell receptor-gamma chain gene from several lesions revealed a monoclonal rearrangement without clonal variation. Two-colour fluorescence in situ hybridization (X and Y chromosomes) and microsatellite genotyping were used to compare samples from the patient (transplant recipient), his sister (donor) and the skin biopsy sample, which confirmed that the origin of the neoplastic cells was the donor graft. To our knowledge, this is the first case of post-transplant primary cutaneous T-cell lymphoproliferative disorder after ASCT.
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Affiliation(s)
- A Santos-Briz
- Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain.
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3
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Kowal M, Hus M, Dmoszynska A, Kocki J, Grzasko N. Acute T cell lymphoblastic leukemia in the recipient of a renal transplant from a donor with malignant lymphoma. Acta Haematol 2008; 119:187-9. [PMID: 18536518 DOI: 10.1159/000137944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 03/21/2008] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Clone Cells/pathology
- Clone Cells/transplantation
- Fatal Outcome
- Female
- Humans
- Immunophenotyping
- Immunosuppression Therapy/adverse effects
- In Situ Hybridization, Fluorescence
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/surgery
- Kidney Transplantation/adverse effects
- Leukemia-Lymphoma, Adult T-Cell/drug therapy
- Leukemia-Lymphoma, Adult T-Cell/etiology
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/pathology
- Male
- Mediastinal Neoplasms/diagnosis
- Mediastinal Neoplasms/pathology
- Middle Aged
- Neoplasms, Unknown Primary/diagnosis
- Neoplasms, Unknown Primary/pathology
- Neoplastic Stem Cells/pathology
- Neoplastic Stem Cells/transplantation
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/etiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Thymus Neoplasms/diagnosis
- Thymus Neoplasms/pathology
- Tissue Donors
- Transplantation, Homologous/adverse effects
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Affiliation(s)
- Malgorzata Kowal
- Department of Hematooncology and Bone Marrow Transplantationt, Medical University of Lublin, Lublin, Poland
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Myron Kauffman H, McBride MA, Cherikh WS, Spain PC, Hanto DW, Delmonico FL. Donor-related malignancies. Transplant Rev (Orlando) 2002. [DOI: 10.1053/trte.2002.128240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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5
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Baehner R, Magrane G, Balassanian R, Chang C, Millward C, Wakil AE, Osorio RW, Waldman FM. Donor origin of neuroendocrine carcinoma in 2 transplant patients determined by molecular cytogenetics. Hum Pathol 2001. [PMID: 11112220 DOI: 10.1016/s0046-8177(00)80015-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Organ transplant recipients have an increased tumor incidence owing to their immunocompromised state. The origin of such tumors, whether donor or recipient, will have a clinical impact on decision-making concerning immunosuppressive therapy, retransplantation, and for recipients of other organs from the same donors. We report molecular cytogenetic determination of donor origin in 2 cases of small-cell neuroendocrine carcinoma developing in sex-mismatched transplant recipients (kidney and liver). Fluorescence in situ hybridization (FISH) analysis was performed on liver core needle biopsy material from the liver transplant patient and on liver fine needle aspiration cytopreparations from the kidney transplant patient. The results for the liver transplant patient were confirmed with microsatellite allelic analysis and with comparative genomic hybridization. In both cases, FISH showed the presence of only X chromosomes within the tumor cells, indicating the donor origin of the neoplasms. FISH is an excellent method to determine neoplastic origin in sex-mismatched transplant patients. HUM PATHOL 31:1425-1429.
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Affiliation(s)
- R Baehner
- Cancer Center, University of California San Francisco, San Francisco, CA 94143, USA
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Otero J, Fresno M, Escudero D, Seco M, González M, Peces R. Detection of occult disease in tissue donors by routine autopsy. Transpl Int 1998. [DOI: 10.1111/j.1432-2277.1998.tb00792.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Ying AJ, Myerowitz PD, Marsh WL. Posttransplantation lymphoproliferative disorder in cardiac transplant allografts. Ann Thorac Surg 1997; 64:1822-4. [PMID: 9436585 DOI: 10.1016/s0003-4975(97)01044-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Posttransplantation lymphoproliferative disorder occurs in 1.5% to 13% of heart transplant recipients and rarely involves the allograft. We report a case of posttransplantation lymphoproliferative disorder restricted to the mitral valve in a heart transplant recipient. Thirteen cases of cardiac allograft involvement by posttransplantation lymphoproliferative disorder are reported in the literature. None are restricted to the allograft. Five specify sites of cardiac involvement. Valvular masses without infection necessitate evaluation for posttransplantation lymphoproliferative disorder involvement of the cardiac allograft valve.
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Affiliation(s)
- A J Ying
- Department of Pathology, The Ohio State University Medical Center, Columbus 43210, USA
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Donovan JA, Simmons FA, Esrason KT, Jamehdor M, Busuttil RW, Novak JM, Grody WW. Donor origin of a posttransplant liver allograft malignancy identified by fluorescence in situ hybridization for the Y chromosome and DNA genotyping. Transplantation 1997; 63:80-4. [PMID: 9000665 DOI: 10.1097/00007890-199701150-00015] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Posttransplantation malignancy in the allograft is a rare complication of orthotopic liver transplantation. In the described case, an abnormal T-tube cholangiogram, performed 6 months after orthotopic liver transplantation between a male donor and a female recipient, prompted needle liver biopsy. A moderately differentiated adenocarcinoma was found. Fluorescence in situ hybridization for the Y chromosome indicated male origin of malignancy. Donor-related disease was confirmed by comparative DNA analysis of genomic sequences from the donor liver, associated tumor, and recipient peripheral blood. Results of these investigations qualified the recipient for a second liver transplant.
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Affiliation(s)
- J A Donovan
- Department of Gastroenterology, Southern California Permanente Medical Group, Kaiser Los Angeles Medical Center, 90027, USA
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9
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Ribas Y, Rafecas A, Figueras J, Benasco C, Fabregat J, Torras J, Cañas C, Valls C, Volpini V, Banchs I. Post-transplant lymphoma in a liver allograft. Transpl Int 1995; 8:488-91. [PMID: 8579742 DOI: 10.1007/bf00335603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We describe the development of a lymphoma in a liver allograft shortly after orthotopic liver transplantation. Aspiration and core biopsies of the nodule were persistently negative so that a diagnosis could not be made until the patient underwent retransplantation, when examination of the liver resection specimen revealed a B-cell lymphoma. Using a rapid technique based on the polymerase chain reaction, we were able to demonstrate that the tumor was of donor origin.
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Affiliation(s)
- Y Ribas
- Liver Transplant Unit, C.S.U. Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
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10
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Ribas Y, Rafecas A, Figueras J, Benasco C, Fabregat J, Torras J, Cañas C, Valls C, Volpini V, Banchs I, Jaurrieta E. Post-transplant lymphoma in a liver allograft. Transpl Int 1995. [DOI: 10.1111/j.1432-2277.1995.tb01561.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Spiro IJ, Yandell DW, Li C, Saini S, Ferry J, Powelson J, Katkov WN, Cosimi AB. Brief report: lymphoma of donor origin occurring in the porta hepatis of a transplanted liver. N Engl J Med 1993; 329:27-9. [PMID: 8505941 DOI: 10.1056/nejm199307013290105] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- I J Spiro
- Department of Radiation Oncology, Massachusetts General Hospital, Boston 02114
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12
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Swerdlow SH. Post-transplant lymphoproliferative disorders: a morphologic, phenotypic and genotypic spectrum of disease. Histopathology 1992; 20:373-85. [PMID: 1316870 DOI: 10.1111/j.1365-2559.1992.tb01007.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The post-transplant lymphoproliferative disorders represent a spectrum of life-threatening, generally Epstein-Barr virus-associated lymphoid proliferations which occur in the setting of exogenous immunosuppression following organ transplantation. Histopathological, phenotypic, genotypic and Epstein-Barr virus studies have revealed a broad range of abnormalities. At one end of the spectrum, they are polymorphic polyclonal proliferations with many features of a florid viral infection and, at the other end, they are monomorphic and monoclonal which would fulfill the criteria for a conventional non-Hodgkin's lymphoma, usually of B-cell type. Some patients have both polyclonal and monoclonal lesions and some have two or more monoclonal populations. Finally, because of the varied appearances, different classification schemes have been developed with reported prognostic implications.
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Affiliation(s)
- S H Swerdlow
- University of Cincinnati College of Medicine, Department of Pathology, OH 45267-0529
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