Epstein-Barr virus (EBV)-associated smooth-muscle tumor arising in a post-transplant patient treated successfully for two PT-EBV-associated large-cell lymphomas. Case report.

摘要: The association of Epstein-Barr virus (EBV) with smooth-muscle tumors was recently reported in the setting acquired immunodeficiency syndrome (AIDS) and post-transplantation. We report a case an EBV-associated tumor arising post-transplant (PT) patient who previously treated successfully for two PT large-cell lymphomas. A 4-year-old girl required cardiac transplantation dilated cardiomyopathy when she aged 23 months. Her regimen included cyclosporine, azothiaprine, diltiazem. At 16 months PT, presented anemia, guaiac-positive stools, abdominal mass diagnosed as diffuse lymphoma B-cell phenotype. Immunosuppressive therapy reduced, interferon i.v. immunoglobulin were initiated. She rapidly developed signs rejection, biopsy performed, revealing grade IIIB rejection. Subsequently, immunosuppressive increased. done large pelvic that immunoblastic lymphoma. After treatment chemotherapy retinoic acid, size markedly decreased. Follow-up computed tomography scan revealed multiple liver nodules. needle showed indeterminate grade. Both lymphomas contained EBV within > 95% cells by (EBER1) situ hybridization, strain type nuclear antigen-2 (EBNA-2) polymerase chain reaction (PCR) identical 30 base-pair deletion (amino acids 346-355) latent membrane protein (LMP)-1 oncogene PCR analysis. Notably, initial subsequent each unique p53 mutation, suggesting they distinct. These data suggest same contributed to pathogenesis both malignant tumor.