POSTTRANSPLANTATION CUTANEOUS B-CELL LYMPHOMA WITH MONOCLONAL EPSTEIN-BARR-VIRUS INFECTION, RESPONDING TO ACYCLOVIR AND REDUCTION IN IMMUNOSUPPRESSION

Posttransplantation lymphoproliferative disorders (PTLDs) represent an important complication of solid organ transplantation, The main causa tive factor of PTLDs seems to be the intensity and type of immunosuppr essive therapy and the frequent occurrence of Epstein-Barr virus infec tion. PTLDs that are disseminated at diagnosis or present late after t ransplantation generally share an unfavorable prognosis and are unlike ly to regress in response to reduction in immunosuppressive therapy. W e describe a case of cutaneous B-cell lymphoma occurring 4 years after heart transplantation in which molecular analysis revealed a monoclon al pattern of Epstein-Barr virus infection and immunoglobulin gene rea rrangement, In spite of its monoclonal nature and late occurrence, the lymphomatous lesions regressed completely after antiviral treatment a nd a reduction in inmunosuppressive therapy.