Epstein-Barr Virus-Positive Extranodal Marginal Zone Lymphoma of Bronchial-Associated Lymphoid Tissue in the Posttransplant Setting: An Immunodeficiency-Related (Posttransplant) Lymphoproliferative Disorder?

Am J Clin Pathol. 2017 Dec 20;149(1):42-49. doi: 10.1093/ajcp/aqx134.

Abstract

Objectives: Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of hematolymphoid proliferations arising in the context of chronic immunosuppression. The common and indolent B-cell lymphomas, including extranodal marginal zone lymphomas (ENMZLs) of mucosa-associated lymphoid tissue (MALT), are excluded from the category of PTLD in the current World Health Organization classification.

Methods: We report a case of Epstein-Barr virus (EBV)-positive bronchial-associated lymphoid tissue (BALT) lymphoma involving the lungs of a transplant patient.

Results: Aside from history of cardiac transplant, young patient age, and EBV positivity, the histopathologic findings were indistinguishable from usual BALT lymphoma.

Conclusions: We review the literature of ENMZL occurring in immunocompromised patients and present this case for consideration that this specific entity is a PTLD. We believe that additional studies might lend strength to the hypothesis that this particular group of EBV-positive, posttransplant ENMZLs merits classification and management as PTLDs.

Keywords: Bronchial-associated lymphoid tissue; Epstein-Barr virus; Extranodal marginal zone lymphoma; Posttransplant lymphoproliferative disorder.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Bronchi / pathology
  • Bronchi / virology
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / pathology
  • Epstein-Barr Virus Infections / virology
  • Female
  • Heart Transplantation / adverse effects*
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Lung / pathology
  • Lung / virology
  • Lymphoid Tissue / pathology
  • Lymphoid Tissue / virology
  • Lymphoma, B-Cell, Marginal Zone / diagnosis*
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, B-Cell, Marginal Zone / virology
  • Lymphoproliferative Disorders / diagnosis*
  • Lymphoproliferative Disorders / pathology
  • Lymphoproliferative Disorders / virology
  • Mucous Membrane / pathology
  • Mucous Membrane / virology