C. Kuhnen et al., MALIGNANT-LYMPHOMA AND COLONIC-CARCINOMA 3 YEARS AFTER HEART-TRANSPLANTATION AND IMMUNOSUPPRESSION, Der Pathologe, 15(2), 1994, pp. 129-133
Three years after heart transplantation and immunosuppressive therapy,
a 66-year-old man suffered from dyspnea and showed symptoms mainly du
e to right heart failure. Malignant tumor cells were discovered within
extensive pleural effusion. Computed tomography revealed two lesions
of the liver suspicious of metastases, and recurrent blood in the stoo
ls was evident. The patient deteriorated rapidly and died 3 weeks afte
r admission. Autopsy findings included an adenocarinoma of the cecum (
grade II) with metastases to the liver. High-grade immunoblastic non-H
odgkin's lymphoma of plasmoblastic differentiation was diagnosed, loca
ted within the mediastinal soft tissues and infiltrating the peri- and
myocardium. Mesenteric lymph nodes were enlarged with histological ve
rification of malignant lymphoma. The lymphatic tumor masses had cause
d considerable compression of the heart and vessels, leading to the si
gns of cardiac failure. The development of metastasizing colonic carci
noma and high-grade immunoblastic non-Hodgkin's lymphoma 3 years after
heart transplantation and immunosuppressive therapy must be considere
d an unusual combination. Malignent lymphomas following heart transpla
ntation have been described several times.