T cell lymphoma involving the graft of a multivisceral organ recipient

Mariana Berho, Ana Viciana, Deborah Weppler, Rene Romero, Andreas Tzakis, Phillip Ruiz

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Posttransplant lymphoproliferative disorders are typically of B cell origin, whereas T cell lymphomas have been rarely documented. We present a case of a non-Hodgkin's T cell lymphoma involving the intestinal graft of a multivisceral transplant patient. The patient was a 7-year-old girl who underwent at age 5 a multivisceral transplant secondary to short gut syndrome. Baseline immunosuppressive therapy consisted of FK506, methylprednisone, and mycophenolate mofetil. At 2 years posttransplant she presented with fever, diarrhea, nausea, and vomiting. Multiple endoscopic biopsies revealed a severe intensity, diffuse and focally nodular lymphocytic infiltrate composed predominantly of small, monomorphic lymphoid cells with scattered plasma cells and abundant eosinophils. Immunohistochemically, the majority of the lymphoid cells expressed the pan T cell marker CD3. Southern blot analysis revealed rearrangement of the T cell receptor β chain gene, with germline configuration of the heavy immunoglobulin chain gene, confirming a clonal T cell genotype. In situ hybridization for Epstein Barr virus revealed rare positive lymphoid cells, that were negative with CD3 by immunohistochemical staining. A detailed clinico-radiological work-up revealed no other sites of involvement by the lymphomatous process. After the diagnosis of posttransplant lymphoproliferative disorder, immunosuppression was reduced with a subsequent partial improvement in the endoscopic appearance of the graft and a focal decrease in the lymphocytic infiltrate seen in the follow-up biopsies. Repeat gene rearrangement studies demonstrated germline configuration of both the T cell receptor β chain gene and the heavy chain immunoglobulin, gene. To our knowledge, this represents the first description of a T cell lymphoma affecting the intestinal allograft of a multivisceral transplant patient.

Original languageEnglish
Pages (from-to)1135-1139
Number of pages5
JournalTransplantation
Volume68
Issue number8
DOIs
StatePublished - Oct 27 1999

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T-Cell Lymphoma
Transplants
Immunoglobulin Heavy Chain Genes
T-Cell Receptor Genes
Lymphoproliferative Disorders
Lymphocytes
Mycophenolic Acid
T-Lymphocytes
Biopsy
Gene Rearrangement
Tacrolimus
Immunosuppressive Agents
Southern Blotting
Plasma Cells
Human Herpesvirus 4
Eosinophils
Non-Hodgkin's Lymphoma
Immunosuppression
Nausea
Vomiting

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

T cell lymphoma involving the graft of a multivisceral organ recipient. / Berho, Mariana; Viciana, Ana; Weppler, Deborah; Romero, Rene; Tzakis, Andreas; Ruiz, Phillip.

In: Transplantation, Vol. 68, No. 8, 27.10.1999, p. 1135-1139.

Research output: Contribution to journalArticle

Berho, M, Viciana, A, Weppler, D, Romero, R, Tzakis, A & Ruiz, P 1999, 'T cell lymphoma involving the graft of a multivisceral organ recipient', Transplantation, vol. 68, no. 8, pp. 1135-1139. https://doi.org/10.1097/00007890-199910270-00013
Berho, Mariana ; Viciana, Ana ; Weppler, Deborah ; Romero, Rene ; Tzakis, Andreas ; Ruiz, Phillip. / T cell lymphoma involving the graft of a multivisceral organ recipient. In: Transplantation. 1999 ; Vol. 68, No. 8. pp. 1135-1139.
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