Lymphomas following cardiac transplantation. Case report and review of the literature

Abstract

The success of allogeneic organ transplantation is in great part due to pharmacologic advances in the area of immunosuppressive therapy. However, this achievement has been attained at the price of an unexpectedly high incidence of malignancies in this transplant population. Lymphoid malignancies predominate in this and other immunodeficiency states. There is some controversy in the literature over the clonal or malignant nature of these proliferations. This paper presents a case of Burkitt-like lymphoma occurring after cardiac transplantation. The role of Epstein-Barr virus in the pathogenesis of this disorder is reviewed as are multidisciplinary approaches to its management.

Infections in solid-organ transplant recipients

“…The incidence of PTLD varies with the organ transplanted; rates of 1% for renal, 1.8 to 4.5% for cardiac, 2.1 to 2.2% for liver, 10% for lung, 11% for kidney-pancreas, 4.5 to 9.4% for heart-lung, and 14% for small bowel transplant recipients have been reported (215,238,475,557,743,765). The process is often multicentric and may involve the central nervous system, eyes, gastrointestinal tract (with bleeding and perforation), liver, spleen, lymph nodes, lungs, allograft, oropharynx, and other organs (2,103,178,183,190,258,334,407,472,475,496,556,559,616,644). Clinical presentations are varied and include a mononucleosislike syndrome with fever, adenopathy, tonsillitis and sore throat, fever (including "fever of unknown origin"), abdominal pain, anorexia, jaundice, bowel perforation, gastrointestinal bleeding, renal dysfunction, hepatic allograft dysfunction, pneumothorax, pulmonary infiltrates, and weight loss (76,250,475,696).…”