EARLY DEVELOPMENT OF EPSTEIN-BARR VIRUS-ASSOCIATED T-CELL LYMPHOMA AFTER A LIVING-RELATED RENAL-TRANSPLANTATION

We herein report a case of Epstein-Barr virus (EBV)associated T-cell l ymphoma that developed within a month after a kidney transplantation. The recipient was a 37-year-old man who had evidence of a previous EBV infection. Cyclosporine, methylprednisolone, and azathioprine were us ed for immunosuppression, and acute rejection was treated with high-do se methylprednisolone, The lactate dehydrogenase level started to incr ease on day 24 and thereafter peaked on day 37 while also demonstratin g progressive jaundice and a bleeding tendency. A transplant nephrecto my was done on day 37; however; the patient could not recover and even tually died of respiratory failure as a result of diffuse pulmonary ed ema. A pathological examination of the resected kidney revealed a diff use proliferation of large atypical lymphoid cells in the parenchyma. Immunohistochemically, the tumor cells were positive for CD45 and T-ce ll marker, CD45RO, but negative for E-cell markers. EBV-encoded RNA wa s demonstrated within the neoplastic cells by in situ hybridization.