Posttransplant lymphoproliferative disease

Most common malignancy, with exception of skin cancer, after solid organ transplants and occurs in up to 10% of patients.

Can occur after any solid organ transplant.

Kidney transplants are associated with the lowest rate of posttransplant lymphoma about 1-2%.

Post transplant lymphoproliferative disorder manifesting after solid organ transplant occurs in approximately 2-3% of cases, with the highest incidence in intestinal and multiple organ transplant recipients (5-20%), followed by lung and hearttransplant (2-10%) and then pancreatic, renal, and liver transplant (1-5%).

Higher rates of posttransplant lymphoma seen with pancreas, pancreas-kidney transplants, liver, lung small bowel and heart-lung transplants.


                                                                                                                                                                                    Epstein-Barr virus associated with such type of lymphomas.

About 50% of post transplant lymphoproliferative disease cases are driven by Epstein-Barr virus infection in the setting of the immunosuppression and subsequent T cell inhibition.

Epstein-Barr virus especially associated with lymphomas that occur less than 1 year after transplantation.

Classified as early lesions, polymorphic and monomorphic posttransplant lymphoproliferative disorders.

Early lesions have reactive plasmacytic hyperplasia, polymorphic abnormalities may have polyclonal or monoclonal disease and characterized by the destruction of underlying lymphoid architecture with necrosis and nuclear atypia.

Majority cases of posttransplant lymphoma are diffuse large B cell lymphoma, while Burkitt’s lymphoma and plasma cell myeloma can also be seen.

Rarely T cell variant lymphomas can occur, while Hodgkin’s disease is very unusual.

About 50% of patients with post transplant lymphoproliferative disease or driven by Epstein bar virus infection in the setting of immunosuppression it sucks with his cell inhibition.

Primary CNS post transplant lymphoproliferative disorder comprises 5-15% of all post transplant lymphoproliferative disease cases.

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