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Int J Clin Exp Pathol 2012;5(4):359-362

Case Report
The efficacy of EBER in situ hybridization (ISH) stain in PTLD (malignant diffuse large
B-cell lymphoma) about 4 years after ABO-incompatible kidney transplantation: a case

Kazuhiro Nose, Takashi Oki, Eri banno, Koichi Sugimoto, Tsukasa Nishioka, Ken Ochiai, Syunji Maekura

Department of Urology, Kinki University faculty of Medicine Sakai Hospital, Sakai city, Japan; Department of Pathology, Kinki University faculty of
Medicine Sakai Hospital, Sakai city, Japan

Received March 15, 2012; accepted April 11, 2012; Epub April 16, 2012; Published May 30, 2012

Abstract: Post-transplant lymphoproliferative disease (PTLD) is a well-known late complication of organ transplantation which incidence has
increased after the introduction of more powerful immunosuppressive agents. A 58-year-old man performed ABO-incompatible living kidney
transplantation in June, 2008. At 3 years and 9 months after the transplantation, the patient complained of general fatigue and dyspnea and
was hospitalized with renal dysfunction. The clinical data in hospital showed acute rejection, but soluble IL-II exceeded 21700U/ml, and HE
staining kidney graft showed a massive infiltration of atypical lymphocytes. Atypical lymphocytes were positive for L-26 and negative for CD3
immunochemical stein, and the EBER in situ hybridization stain for EBV was negative in renal graft. We diagnosed diffuse large B-cell
lymphoma in the kidney graft. However, he died due to multiple organ failure (MOF). We described a fatal case of diffuse large B-cell lymphoma
without EBV infection occurring 3 years 9 months after ABO-incompatible kidney transplantation. Unfortunately, his biopsy after his death using
EBER-ISH stain showed whether EB virus infection was a cause.

Keywords: PTLD, ABO-incompatible living kidney transplantation, EBER in situ hybridization stain

Address all correspondence to:
Dr. Kazuhiro Nose
Department of Urology
Kinki University faculty of Medicine
Sakai Hospital 2-7-1, Harayamadai Minami-ku, Sakai city, Japan.
Tel: (084) 0722991120; Fax: (084)0722986691
E-mail: kams.nose@sakai.med.kindai.ac.jp