EBV-associated B- and T-cell posttransplant lymphoproliferative disorders following primary EBV infection in a kidney transplant recipient

Am J Clin Pathol. 2005 Feb;123(2):222-8.


Posttransplant lymphoproliferative disorders (PTLDs) usually are of B-cell lineage and associated with Epstein-Barr virus (EBV). PTLDs of T-cell lineage are much less common and infrequently associated with EBV. We report a rare case of a girl in whom B-cell and T-cell PTLDs developed following 2 EBV-negative kidney transplants. Within 2 years of the second transplantation, the originally EBV-negative patient developed both an EBV-associated clonal B-cell PTLD involving lymph nodes and an EBV-positive T-cell PTLD involving bone marrow and liver. These proliferations occurred concurrently with evidence of primary EBV infection and high plasma viral load. The patient eventually died of multiorgan failure 5 years after the initial transplant (3 years after the second transplant). To our knowledge, only 4 cases of both B-cell and T-cell PTLDs have been reported. Only 2 cases have been proven to be monoclonal and EBV-associated, as in this case, the first following kidney transplantation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • B-Lymphocytes / immunology
  • B-Lymphocytes / pathology*
  • Bone Marrow / pathology
  • Bone Marrow / virology
  • Cell Proliferation
  • Child, Preschool
  • Clone Cells
  • DNA, Neoplasm / analysis
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / genetics
  • Epstein-Barr Virus Infections / pathology*
  • Fatal Outcome
  • Female
  • Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / genetics
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immunophenotyping
  • Kidney Transplantation*
  • Liver / pathology
  • Liver / virology
  • Lymph Nodes / pathology
  • Lymph Nodes / virology
  • Lymphoproliferative Disorders / genetics
  • Lymphoproliferative Disorders / pathology*
  • Lymphoproliferative Disorders / virology
  • Postoperative Complications*
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology*


  • DNA, Neoplasm