Chorioretinal post-transplant lymphoproliferative disorder induced by the Epstein-Barr virus

Background-The Epstein-Barr virus (EBV) is responsible for the lymphoprolif erative disorders observed in transplanted patients. Methods-The case history is described of a 59 year old man with a chorioret inal lesion who had received a single lung transplant and was on immunosupp ressive treatment. Immunoglobulin gene rearrangement and EBV detection by p olymerase chain reaction (PCR) with semiquantification were used on the vit reous material. Results-A proliferation of B lymphocytes with a monoclonal subpopulation wa s found by PCR on the vitreous sample. The large amounts of EBV genomes fou nd in the vitreous suggest that EBV was the cause of the lymphoproliferatio n. Healing of the lesion was achieved by a decrease in immunosuppressive tr eatment and the use of nucleotide analogues. Conclusion-The diagnosis of ocular posttransplant lymphoproliferative disor der (PTLD) can be made by PCR on vitreous material. Early diagnosis and tre atment can lead to regression of limited monoclonal lesions.