Early post-transplant lymphoproliferative disease following heart transplantation in the absence of lymphocytolytic induction therapy

We report a case of post-transplant lymphoproliferative disease presenting as a disseminated polymorphous B-cell lymphoma involving the cardiac allogr aft 3 months following transplantation in a recipient who did not receive a nti-lymphocyte induction immunosuppression. In situ hybridization for the l ytic Epstein-Barr virus marker NOT I was positive within a lymphocytic infi ltrate on endomyocardial biopsy. Our case is the third of early post-transp lant lymphoproliferative disease (within 6 months of transplantation) invol ving the heart allograft in the absence of anti-lymphocyte induction immuno suppression. Post-transplant lymphoproliferative disease of the heart allog raft should be considered in the presence of an atypical cardiac lymphocyti c infiltrate, with possible differentiation from allograft rejection using in situ hybridization for Epstein-Barr virus.