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Posttransplant Lymphoproliferative Disorders (PTLDs)

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Practical Lymph Node and Bone Marrow Pathology

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Abstract

Posttransplant lymphoproliferative disorders (PTLDs) are lymphoid or plasmacytic proliferations that develop in solid organ, bone marrow, or stem cell allograft recipients in a setting of immunosuppression. PTLDs’ spectrum ranges from usually EBV-driven reactive lymphoid/plasmacytic proliferations to EBV+ or EBV− monoclonal lymphomas or plasmacytic neoplasms, as well as classical Hodgkin lymphoma, indistinguishable from true B-cell/plasma cell or less often T/NK-cell lymphomas occurring in immunocompetent individuals. There are four major categories of PTLD: nondestructive, polymorphic (P-PTLD), monomorphic (M-PTLD), and classical Hodgkin lymphoma (HL-PTLD) PTLDs. Nondestructive PTLDs, including plasmacytic hyperplasia, infectious mononucleosis, and florid follicular hyperplasia, are characterized by some degree of architecture preservation of the involved tissue, with preservation of the nodal sinuses or tonsillar crypts, and residual or florid reactive follicles (FFH) in some cases but an absence of any diagnostic features of a malignant lymphoma of the latter three categories or other known explanations and nonspecific chronic inflammatory processes.

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References

  1. Harris NL, Swerdlow SH, Frizzera G, et al. Post-transplant lymphoproliferative disorders. In: Jaffe E, Harris N, Stein H, et al., editors. Pathology and genetics: tumours of haematopoietic and lymphoid tissues. World Health Organization classification of Tumuors. Lyon: IARC Press; 2001. p. 264–9.

    Google Scholar 

  2. Swerdlow SH, Webber SA, Chadburn A, Ferry JA. Post-transplant lymphoproliferative disorders. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC Press; 2008. p. 335–51.

    Google Scholar 

  3. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization (WHO) classification of lymphoid neoplasms. Blood. 2016;127(20):2375–90.

    Google Scholar 

  4. Swerdlow SH, Webber SA, Chadburn A, Ferry JA. Post-transplant lymphoproliferative disorders. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of Tumours of Haematopoietic and lymphoid tissues. Revised 4th ed. Lyon: IARC Press; 2017. p. p453–62.

    Google Scholar 

  5. Al-Mansour Z, Nelson BP, Evens AM. Post-transplant lymphoproliferative disease (PTLD): risk factors, diagnosis, and current treatment strategies. Curr Hematol Malig Rep. 2013;8(3):173–83.

    Google Scholar 

  6. San-Juan R, Comoli P, Caillard S, Moulin B, Hirsch HH, Meylan P, et al. Epstein-Barr virus-related post-transplant lymphoproliferative disorder in solid organ transplant recipients. Clin Microbiol Infect. 2014;20(Suppl 7):109–18.

    Google Scholar 

  7. Perry AM, Aoun P, Coulter DW, Sanger WG, Grant WJ, Coccia PF. Early onset, EBV(−) PTLD in pediatric liver-small bowel transplantation recipients: a spectrum of plasma cell neoplasms with favorable prognosis. Blood. 2013;121(8):1377–83.

    Google Scholar 

  8. Lones MA, Mishalani S, Shintaku IP, Weiss LM, Nichols WS, Said JW. Changes in tonsils and adenoids in children with posttransplant lymphoproliferative disorder: report of three cases with early involvement of Waldeyer’s ring. Hum Pathol. 1995;26(5):525–30.

    Google Scholar 

  9. Dotti G, Fiocchi R, Motta T, et al. Primary effusion lymphoma after heart transplantation: a new entity associated with human herpes virus-8. Leukemia. 1999;13:664–70.

    Google Scholar 

  10. Chen W, Huang Q, Zuppan C, Rowsell EH, Cao JD, Weiss LM, Wang J. Complete absence of KSHV/HHV-8 in post-transplant lymphoproliferative disorders – an immunohistochemical and molecular study of 52 cases. Am J Clin Pathol. 2009;131:632–9.

    Google Scholar 

  11. Vakiani E, Nandula SV, Subramaniyam S, Keller CE, Alobeid B, Murty VV, Bhagat G. Cytogenetic analysis of B-cell posttransplant lymphoproliferations validates the World Health Organization classification and suggests inclusion of florid follicular hyperplasia as a precursor lesion. Hum Pathol. 2007;38(2):315–25.

    Google Scholar 

  12. Nelson BP, Wolniak KL, Evens A, Chenn A, Maddalozzo J, Proytcheva M. Early posttransplant lymphoproliferative disease: clinicopathologic features and correlation with mTOR signaling pathway activation. Am J Clin Pathol. 2012;138(4):568–78.

    Google Scholar 

  13. Mucha K, Foroncewicz B, Ziarkiewicz-Wroblewska B, Krawczyk M, Lerut J, Paczek L. Post-transplant lymphoproliferative disorder in view of the new WHO classification: a more rational approach to a protean disease? Nephrol Dial Transplant. 2010;25(7):2089–98.

    Google Scholar 

  14. Gibson SE, Swerdlow SH, Craig FE, Surti U, Cook JR, Nalesnik MA, et al. EBV-positive extranodal marginal zone lymphoma of mucosa-associated tissue in posttransplant setting: a distinct type of posttransplant lymphoproliferative disorder? Am J Surg Pathol. 2011;35(6):807–15.

    Google Scholar 

  15. Morscio J, Finalet Ferreiro J, Vander Borght S, Bittoun E, Gheysens O, Dierickx D, et al. Identification of distinct subgroups of EBV-positive post-transplant diffuse large B-cell lymphoma. Mod Pathol. 2017;30(3):370–81.

    Google Scholar 

  16. Sarkozy C, Kaltenbach S, Faurie P, Canioni D, Berger F, Traverse-Glehen A, et al. Array-CGH predicts prognosis in plasma cell post-transplantation lymphoproliferative disorders. Genes Chromosomes Cancer. 2017;56(3):221–30.

    Google Scholar 

  17. Trappe R, Zimmermann H, Fink S, Reinke P, Dreyling M, Pascher A, et al. Plasmacytoma-like post-transplant lymphoproliferative disorder, a rare subtype of monomorphic B-cell post-transplant lymphoproliferation, is associated with a favorable outcome in localized as well as in advanced disease: a prospective analysis of 8 cases. Haematologica. 2011;96(7):1067–71.

    Google Scholar 

  18. Tcheng WY, Said J, Hall T, Al-Akash S, Malogolowkin M, Feig SA. Post-transplant multiple myeloma in a pediatric renal transplant patient. Pediatr Blood Cancer. 2006;47(2):218–23.

    Google Scholar 

  19. Pitman S, Rowsell EH, Cao JD, Huang Q, Wang J. Anaplastic large cell lymphoma associated with Epstein-Barr virus following cardiac transplant. Am J Surg Pathol. 2004;28(3):410–5.

    Google Scholar 

  20. Wang J, Pitman S, Rowsell EH, Cao JD, Huang Q. What is anaplastic large cell lymphoma? Authors’ reply. Am J Surg Pathol. 2004;28(12):1664–7.

    Google Scholar 

  21. Adams H, Campidelli C, Dirnhofer S, Pileri SA, Tzankov A. Clinical, phenotypic and genetic similarities and disparities between post-transplant and classical Hodgkin lymphomas with respect to therapeutic targets. Expert Opin Ther Targets. 2009;13(10):1137–45.

    Google Scholar 

  22. Mohri T, Ikura Y, Hirakoso A, Okamoto M, Hishizawa M, Takaori-Kondo A, et al. Classical Hodgkin lymphoma type post-transplant lymphoproliferative disorder in a kidney transplant recipient: a diagnostic pitfall. Int J Hematol. 2018;108(2):218–27.

    Google Scholar 

  23. Ranganathan S, Webber S, Ahuja S, Jaffe R. Hodgkin-like post-transplant lymphoproliferative disorder in children: does it differ from post-transplant Hodgkin lymphoma? Pediatr Dev Pathol. 2004;7(4):348–60.

    Google Scholar 

  24. Pitman S, Huang Q, Zuppan C, Rowsell EH, Cao JD, Berdeja JG, Weiss LM, Wang J. Hodgkin Lymphoma-like (HD-like) Post-Transplant Lymphoproliferative Disorder (PTLD) simulates monomorphic B-cell PTLD both Clinically and Pathologically. Am J Surg Pathol. 2006;30(4):470–6.

    Google Scholar 

  25. Semakula B, Rittenback J, Wang J. Hodgkin lymphoma-like post-transplant lymphoproliferative disorder. Arch Pathol Lab Med. 2006;130(4):558–60.

    Google Scholar 

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Authors and Affiliations

  1. Pathology and Laboratory Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA

    Jun Wang

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  1. Jun Wang
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Correspondence to Jun Wang .

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Editors and Affiliations

  1. Department of Pathology, Duke University School of Medicine and Duke Health System, Durham, NC, USA

    Endi Wang

  2. Department of Pathology, Duke University School of Medicine and Duke Health System, Durham, NC, USA

    Anand Shreeram Lagoo

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Wang, J. (2020). Posttransplant Lymphoproliferative Disorders (PTLDs). In: Wang, E., Lagoo, A.S. (eds) Practical Lymph Node and Bone Marrow Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-32189-5_10

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  • DOI: https://doi.org/10.1007/978-3-030-32189-5_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-32188-8

  • Online ISBN: 978-3-030-32189-5

  • eBook Packages: MedicineMedicine (R0)

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