Hodgkin-like lymphoma, simulating anaplastic large cell lymphoma in the patient after renal transplantation - Unusual case report and literature review

Bogna Ziarkiewicz-Wróblewska, B. Górnicka, B. Gierej, W. Suleiman, E. Nowacka-Cieciura, M. Durlik, M. Bogdańska, A. Wasiutyński, S. A. Pileri

Research output: Contribution to journalArticlepeer-review

Abstract

We report the atypical case of posttransplant lymphoproliferative disorder (PTLD) diagnosed in 55-year men 9 years after renal transplantation. It was evaluated only by bone marrow biopsy, which showed its total involvement with malignant lymphoma. It was composed of two populations of lymphoid cells: large RS-like cells and small to medium ones, with slightly angular nuclei without visible nucleoli. Both cell populations did not show positive reaction for typical B cell markers (CD20, CD79a). Large RS-like cells were positive with CD30 and EBV-LMP. However, negative reaction with CD15 and positive reactions with UCHL1 and EMA were not consistent with classical type of Hodgkin lymphoma. Morphological picture and immunophenotype had suggested anaplastic T cell lymphoma. Because of negative reaction with ALK1, initial diagnosis was ALCL ALK-negative. Then, additional stains with BOB1 and Oct2 were performed, which were positive. Taking it into account the diagnosis was changed; finally Hodgkin-like B lymphoma was diagnosed. The patient was treated with CHOP regimen with good response. 5 years after primary diagnose of PTLD he is steel free of disease. Conclusions: 1. Apart from typical forms of PTLD, one may expect cases with nonspecific morphological picture and phenotype. 2. Negative reactions with typical immunohistochemical markers for lymphocytes of B cell line do not exclude the possibility of B-cell proliferation.

Original languageEnglish
Pages (from-to)63-69
Number of pages7
JournalPolish Journal of Pathology
Volume59
Issue number1
Publication statusPublished - 2008

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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