• Internal medicine · Feb 2025

    Case Reports

    Autopsy Case of Epstein-Barr Virus-associated T-cell Post-transplant Lymphoproliferative Disorder with Mono- and Polymorphic Lesions: Possibility of 'Polymorphic T-cell Post-transplant Lymphoproliferative Disorder'.

    • Keijiro Sato, Toshimitsu Ueki, Takayoshi Tokutake, Masahide Watanabe, Shohei Shigeto, Hiroyuki Kanno, Masahiko Sumi, and Hikaru Kobayashi.
    • Department of Hematology, Nagano Red Cross Hospital, Japan.
    • Intern. Med. 2025 Feb 1; 64 (3): 439447439-447.

    AbstractEpstein-Barr virus (EBV)-associated post-transplant lymphoproliferative disease (PTLD) is predominantly of B cell origin. The concept of clonal evolution from poly- to monoclonal lymphoproliferation has been put forward, but T-cell PTLDs are rare with an unknown etiology. In a unique autopsy case of a 53-year-old man with EBV-associated T-cell PTLD, we observed polymorphic T-cell proliferation across several organs and monomorphic T-cell proliferation in the perforated ileum. Interestingly, both manifestations exhibited identical monoclonal peaks in the T-cell receptor rearrangement polymerase chain reaction (PCR) analyses. These findings suggest the existence of clonal evolution in EBV-associated T-cell PTLD, leading to the proposal of the novel concept of polymorphic T-cell PTLD.

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