Primary Intrarenal Posttransplant Lymphoproliferative Disorder Detected by Surveillance Protocol Biopsy.

摘要

PTLD is estimated to occur in 1–5% of renal transplantudrecipients. Primary intrarenal localization is extremely rareudand is generally diagnosed late, because of ambiguousudclinical presentation (2). We detected primary intrarenaludlymphoplasmacellular early PTLD in a 5-year-old kidneyudtransplant recipient by renal allograft protocol biopsy. Atudage 3, the boy underwent renal transplantation from auddeceased donor because of end stage renal disease associatedudwith Prune–Belly syndrome. Immunosuppressiveudtherapy included daclizumab, steroids, tacrolimus, and mycophenolate mofetil. Pretransplant EBV serology was negative.udAccording to our protocol,uda surveillance renal allograft biopsy was performed, whichudrevealed severe lymphomonocytes infiltration with CD3+udT lymphocytes, CD20+ B lymphocytes, CD79a+ plasmaudcells, and rare CD68+ monocytes. C4d staining was negative.udEBV in situ hybridization showed numerous positiveudcells, consistent with EBV-associated intrarenal early PTLD