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International Journal of Hematology

, Volume 108, Issue 2, pp 218–227 | Cite as

Classical Hodgkin lymphoma type post-transplant lymphoproliferative disorder in a kidney transplant recipient: a diagnostic pitfall

  • Taro Mohri
  • Yoshihiro Ikura
  • Asako Hirakoso
  • Masashi Okamoto
  • Masakatsu Hishizawa
  • Akifumi Takaori-Kondo
  • Seiichi Kato
  • Shigeo Nakamura
  • Kai Yoshimura
  • Hidetoshi Okabe
  • Yasuhiro Iwai
Case Report

Abstract

We report a case of classical Hodgkin lymphoma type post-transplant lymphoproliferative disorder (HL-PTLD) after kidney transplantation to highlight the difficulty of distinguishing this disorder from Hodgkin lymphoma-like PTLD (HL-like PTLD). Through this case report and literature review, we seek to clarify definitive pathologic features to differentiate these two conditions. A 38-year-old male kidney transplant recipient who had been receiving immunosuppressants was admitted to our hospital with unidentified high fever. Computed tomography images and blood tests indicated a lymphoproliferative disorder. Abdominal lymph node biopsy was performed, and microscopic examination revealed the presence of many large atypical cells in a background of dense T cell accumulation. The large, atypical cells were positive for Epstein–Barr Virus (EBV)-encoded small RNAs (EBER) in situ hybridization, EBV-LMP1, CD30 and PAX5, but negative for CD15, CD20 and CD45. Except for CD15-negativity, this immunohistochemical pattern was consistent with that of classical Hodgkin lymphoma. By close examination of the above immunoreactivities and the patient’s subsequent chemosensitive clinical course, we finally made a diagnosis of HL-PTLD.

Keywords

Classical Hodgkin lymphoma Post-transplant lymphoproliferative disorder Immunohistochemistry 

Notes

Acknowledgements

The authors thank Mr. Ben Phillis, Wakayama Medical University, for proofreading and editing the manuscript.

Compliance with ethical standards

Conflict of interest

All authors have nothing to disclose.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Taro Mohri
    • 1
    • 2
  • Yoshihiro Ikura
    • 1
  • Asako Hirakoso
    • 1
    • 2
  • Masashi Okamoto
    • 3
  • Masakatsu Hishizawa
    • 4
  • Akifumi Takaori-Kondo
    • 4
  • Seiichi Kato
    • 5
    • 6
  • Shigeo Nakamura
    • 5
  • Kai Yoshimura
    • 1
  • Hidetoshi Okabe
    • 1
  • Yasuhiro Iwai
    • 1
  1. 1.Department of PathologyTakatsuki General HospitalTakatsukiJapan
  2. 2.Department of PathologyKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of HematologyTakatsuki General HospitalTakatsukiJapan
  4. 4.Department of HematologyKyoto University HospitalKyotoJapan
  5. 5.Department of Pathology and Laboratory MedicineNagoya University Graduate School of MedicineNagoyaJapan
  6. 6.Department of Pathology and Molecular DiagnosticsAichi Cancer Center HospitalNagoyaJapan

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