Multiple leiomyosarcomas of both donor and recipient origin arising in a heart-lung transplant patient

Gino R. Somers, Andrea A. Tesoriero, Elizabeth Hartland, Colin F. Robertson, Philip J. Robinson, Deon J. Venter, C. W. Chow

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Abstract

The occurrence of Epstein-Barr virus-associated smooth-muscle tumors in immunocompromised patients has been reported, particularly in the pediatric population. In posttransplantation tumors, the tissue of origin has been either donor or recipient. Mixed-genotype sarcomas within the same patient have not yet been reported. We describe the occurrence of multiple leiomyosarcomas of both donor (arising in the lung allograft) and recipient (arising in the host liver) origin in a 15-year-old boy 3 years after heart- lung transplantation. Analysis of premortem lung tumors demonstrated the presence of Epstein-Barr virus DNA. Despite decreasing immunosuppression and commencing acyclovir, the patient died of systemic Pseudomonas infection. Immunohistochemical analysis revealed that both lung and liver tumors were negative for the Epstein-Bart virus receptor (CD21), and suggests that Epstein-Barr virus entry into the cells was not via this receptor but via an alternate mechanism such as cell fusion.

Original languageEnglish
Pages (from-to)1423-1428
Number of pages6
JournalAmerican Journal of Surgical Pathology
Volume22
Issue number11
DOIs
Publication statusPublished - 1 Nov 1998

Keywords

  • Acyclovir
  • DNA fingerprinting
  • Epstein-Barr virus
  • Heart-lung transplantation
  • Leiomyosarcomas

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