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首页> 外文期刊>Neuropathology: official journal of the Japanese Society of Neuropathology >A case of Epstein-Barr virus associated post-transplant lymphoproliferative disorder with CNS involvement: pathological findings at both biopsy and autopsy.
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A case of Epstein-Barr virus associated post-transplant lymphoproliferative disorder with CNS involvement: pathological findings at both biopsy and autopsy.

机译：一例爱泼斯坦-巴尔病毒与中枢神经系统受累相关的移植后淋巴组织增生性疾病：活检和尸检的病理结果。

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摘要

Post-transplant lymphoproliferative disorder (PTLD) with CNS involvement is an uncommon and fatal side effect of immunosuppressants. A 55-year-old man presented with non-fluent aphasia, fever, neck stiffness and disturbance of consciousness. Twenty-one years previously, the patient had undergone kidney transplantation for chronic renal failure. Brain MRI revealed multiple lesions in the bilateral cerebrum, right cerebellum and medulla oblongata. The brain biopsy showed EBV-positive lymphocytes infiltrating into the subarachnoid and Virchow-Robins space. The diagnosis of PTLD was made and the patient received a reduction in immunosuppressants. However, the patient died of massive bleeding from a rectal ulcer 3 months after the onset. An autopsy conducted 1 month after the biopsy revealed a diffuse large B-cell lymphoma at the biopsy site and extracranial PTLD lesions. Moreover, a human cytomegalovirus infection involving the rectum, pancreas, trachea and bladder was confirmed. Comparisons with past cases clarified the characteristics of this case, in particular, the clinicopathological involvement of leptomeninges. In addition, there have so far been only a limited number of such reports demonstrating detailed pathological findings, including both biopsy and autopsy findings. We herein describe the relationship between clinical and pathological findings and demonstrate the way CNS PTLD lesion progresses.
机译：涉及CNS的移植后淋巴细胞增生性疾病（PTLD）是免疫抑制剂罕见且致命的副作用。一名55岁的男性表现为非流利性失语，发烧，颈部僵硬和意识障碍。 21年前，该患者因慢性肾功能衰竭接受了肾脏移植。脑MRI显示双侧大脑，右小脑和延髓有多个病变。脑活检显示EBV阳性淋巴细胞浸润到蛛网膜下腔和Virchow-Robins空间。诊断为PTLD，患者免疫抑制剂减少。然而，该患者在发病3个月后因直肠溃疡大量出血而死亡。活检后1个月进行的尸检显示，在活检部位有弥漫性大B细胞淋巴瘤和颅外PTLD病变。此外，已证实人类巨细胞病毒感染涉及直肠，胰腺，气管和膀胱。与以往病例的比较阐明了该病例的特征，特别是软脑膜炎的临床病理学影响。此外，到目前为止，仅有少量此类报告显示了详细的病理发现，包括活检和尸检结果。我们在此描述临床和病理结果之间的关系，并证明中枢神经系统PTLD病变进展的方式。

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