INTRAGRAFT ANGIOTROPIC LARGE-CELL LYMPHOMA OF T-CELL-TYPE IN A LONG-TERM RENAL-ALLOGRAFT RECIPIENT

Chronic immune suppression is a risk for the development of post-trans plantation lymphoproliferative disorders, which are frequently caused by a B-cell dyscrasia We report a unique primary presentation of the r are angiotropic lymphoma in a kidney allograft, 18 years after transpl antation. The diagnosis was made by a percutaneous allograft biopsy sp ecimen when the recipient presented with renal dysfunction and intermi ttent hematuria Immunostaining of the biopsy specimen revealed a T-cel l lineage of the neoplastic cells rather than the more common B-cell s ource. At the time of biopsy, there was no evidence of systemic dissem ination of lymphoma The intragraft lymphoma resolved completely after chemotherapy, but the patient died 6 months later as a result of an in tracerebral hemorrhage. At autopsy, intravascular lymphoma was only fo und in the cerebral vessels. To the authors' knowledge, this is the fi rst report of angiotropic T-cell lymphoma in a kidney allograft. A des cription of the clinical, pathologic, and immunohistochemical features of this case is provided, as well as reviews of previous reports of r enal angiotropic lymphoma and post-transplantation T-cell lymphomas.