The pathology of liver-localized post-transplant lymphoproliferative disease - A report of three cases and a review of the literature

Post-transplantation lymphoproliferative disease (PTLD) is a complication o f solid organ transplantation that is typically of B-cell origin and associ ated with Epstein-Barr virus (EBV). In patients receiving orthotopic liver transplantation (OLT) and treated with cyclosporin A, PTLD typically presen ts between 6 and 17 months post-transplantation as a systemic illness with involvement of the hepatic graft in a minority of cases. A small number of cases of biopsy-proven PTLD arising in the hepatic graft and limited to the liver and periportal structures have been previously reported. This report describes three additional cases of liver-localized PTLD and reviews simil ar cases in the Literature. The donor/host origin of PTLD may have prognost ic significance because the two cases in this report that are of donor orig in had different clinical and pathologic features compared with the case of host origin. A rapid PCR-based technique for determining the origin of PTL D is described.