Korean J Nephrol.  2004 Mar;23(2):358-363.

NK/T-cell Lymphoma Involving Multiple Organs in Renal Transplant Recipient

• Kim SW
• Sung SA
• Jo SK
• Cho WY
• Kim HK
• Won NH

Abstract

Posttransplant lymphoproliferative disorders (PTLDs) represent a potentially life-threatening complication following renal transplantation. Their incidence is usually low, in the range of 1-2%. The majority of PTLD is B cell origin and strongly associated with Epstein Barr virus (EBV). PTLD of T cell origin is uncommon and has a poor prognosis. We have experienced a case of NK/T cell lymphoma involving stomach, mesenteric lymph nodes, and heart after renal transplantation. The patient was 34 years old man who received renal transplant in 1999. He was admitted with a complaint of fever and pancytopenia for 2 weeks in 2003. Though antibiotic and antifungal treatment, fever and pancytopenia were continued. On the third hospital day, he present waterly diarrhea. We found multiple hemorrhagic erosions in the stomach by gastrofiberscopy and did biopsy there. Gastric mucosal biopsy showed infiltration by atypical cells between the mucosal glands and submucosal layer. The immunophenotype of these tumor cells were CD3+, UCHL+, and CD56+ and all negative for B cell markers. He was dead because of massive gastrointestinal bleeding after endoscopic biopsy of stomach. The autopsy revealed the widespreading of tumor cells involving heart and mesenteric lymph nodes.

Keyword

Posttransplant lymphoproliferative disorder; NK/T cell lymphoma; Stomach; Heart; Fever

MeSH Terms

Adult
Autopsy
Biopsy
Diarrhea
Fever
Heart
Hemorrhage
Herpesvirus 4, Human
Humans
Incidence
Kidney Transplantation
Lymph Nodes
Lymphoma*
Lymphoproliferative Disorders
Pancytopenia
Prognosis
Stomach
Transplantation*