• Mononucleosis-like symptoms (eg, fever, night sweats, hepatosplenomegaly,
lymphadenopathy)
Manifestations
• Extranodal mass in approximately 50%
• Biopsy findings: polyclonal or monoclonal B-cell proliferation
This patient underwent solid organ transplantation and is on high-dose immunosuppressive medications due to
acute graft rejection. He subsequently developed mononucleosis-like symptoms (eg, fever, night sweats,
lymphadenopathy, hepatosplenomegaly, leukopenia) with biopsy showing large, atypical B cells completely
effacing the lymph node architecture. This constellation of findings likely indicates posttrans plantation
lymphoproliferative disorder (PTLD).
PTLD is a plasmocytic or lymphoid proliferation that occurs in the weeks or months following solid-organ or
hematopoietic stem cell transplantation. It is generally caused by proliferation of Epstein-Barr virus (EBV) in
donor or host cells due to reduced cytotoxic T-cell immunosurveillance from high dose immunosuppressive
therapy.
EBV replication promotes B-cell proliferation due to the expression of viral membrane proteins (latent membrane
protein 1/2A) that mimic B-cell antigen stimulation signals; it also promotes B-cell survival due to the expression
of viral nuclear transcription factors (EBNA-2/LP) that activate host survival genes. These virus-mediated changes
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller newtef39. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £5.56. You're not tied to anything after your purchase.
