Clinical and Pathological Features of Posttransplantation Lymphoproliferative Disorders Presenting With Skin Involvement in 4 Patients

Beynet, David; Wee, Sue Ann; Horwitz, Steven; Kohler, Sabina; Horning, Sandra J.; Hoppe, Richard T.; Kim, Youn H.

doi:10.1001/archderm.140.9.1140

Cited by 45 publications

(44 citation statements)

References 28 publications

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“…PTLD affects 1-5% of solid OTR, but primary cutaneous lymphomas in OTR appear to be rare and so far only a few cases have been reported. They develop 5-8 years after organ transplantation [1,49]. According to the WHO classification (2008; 4th edition), PTLD is classified as early lesions, polymorphic, monomorphic PTLD and classic Hodgkin lymphoma-type PTLD [50].…”

Section: Cutaneous Lymphomasmentioning

confidence: 99%

“…The epidemiology and composition of cutaneous B cell lymphomas in OTR differ significantly from those in immunocompetent patients. In OTR, B cell lymphomas are often monomorphic and of large-cell morphology (centroblastic, immunoblastic and plasmablastic) [49]. The vast majority are associated with Epstein-Barr virus as shown by the presence of Epstein-Barr virus RNA transcripts (EBER) by in situ hybridization.…”

Section: Cutaneous Lymphomasmentioning

confidence: 99%

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Skin Cancer in Organ Transplant Recipients

Kempf¹,

Mertz²,

Hofbauer

et al. 2013

Pathobiology

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Organ transplant recipients (OTR) are at a significantly increased risk for developing a wide variety of skin cancers, particularly epithelial skin cancer, Merkel cell carcinoma and Kaposi's sarcoma. Melanoma, skin adnexal neoplasm and cutaneous lymphomas are also more common in OTR and may differ in their clinicopathologic presentation from tumors in immunocompetent patients. The accuracy of clinical diagnosis of suspected premalignant and malignant skin lesions in OTR is modest. Therefore, histopathological diagnosis is an essential element for the diagnostic workup of skin cancers and, in addition, provides important information on prognosis. Squamous cell carcinoma and intraepithelial neoplasias (actinic keratosis, squamous cell carcinoma in situ or Bowen's disease) are the most common forms of skin cancer in OTR. The risk of Merkel cell carcinoma and Kaposi's sarcoma is dramatically increased in OTR. Merkel cell carcinoma shows a highly aggressive course. Kaposi's sarcoma tends to spread to extracutaneous sites. Primary cutaneous lymphomas developing after organ transplantation are rare. The spectrum of cutaneous B cell lymphomas in OTR, in particular, differs significantly from that of the general population, with a predominance of Epstein-Barr virus-driven posttransplant lymphoproliferative disorder. This review discusses the clinical and histopathological aspects of skin cancers in OTR, the impact of dermatopathological analysis on prognosis and the understanding of the pathogenesis of these neoplasms.

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Section: Cutaneous Lymphomasmentioning

confidence: 99%

Section: Cutaneous Lymphomasmentioning

confidence: 99%

Skin Cancer in Organ Transplant Recipients

Kempf¹,

Mertz²,

Hofbauer

et al. 2013

Pathobiology

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“…In this respect, PTLD contrasts with NHL in the general population where only around 1% of cases shows isolated CNS involvement. Skin involvement is observed in approximately 5-10% of all PTLD patients and must be differentiated by other cutaneous malignancy, given the fact that organ allograft recipients have an increased risk for the development of cutaneous malignancy such as squamous and basal cell carcinoma (Beynet DP et al, 2004). The Canadian PTLD Survey Group analysed 90 cases of PTLD occurring in 4283 solid organ transplant recipients followed over a nine-year period (Allen U et al, 2001).…”

Section: Clinical Presentationmentioning

confidence: 99%

Post Transplant Lymphoproliferative Disorders After Liver Transplantation

Marino¹,

Aversa²,

Stragliotto³

et al. 2012

Liver Transplantation - Technical Issues and Complications

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“…Because the GI tract is also frequently involved, GI signs and symptoms such as diarrhoea and bleeding may also lead to a diagnosis of PTLD, headache or confusion in case of CNS involvement, nasal airway obstruction in case of sinonasal PTLD involvement, or subtle orbital symptoms in case of orbital PTLD. Skin involvement is observed in approximately 5-10% of all PTLD patients and must be differentiated by other cutaneous malignancy, given the fact that organ allograft recipients have an increased risk for the development of cutaneous malignancy such as squamous and basal cell carcinoma (Allen et al, 2001;Maecker et al, 2007;Beynet et al, 2004). Given this myriad of nonspecific clinical signs and symptoms, often masquerading PTLD as infection or adverse drug effects or reactions, or even absence of symptoms at all, methods for early detection of PTLD in transplant recipients would be extremely valuable.…”

Section: Clinical Presentationmentioning

confidence: 99%