Posttransplant Lymphoproliferative Disorder

FIGURE 10-17

Posttransplant lymphoproliferative disorder (PTLD). The least satisfying facet of the 1997 Fourth Banff Conference on Allograft Pathology was the continued lack of good tools for the renal pathologist trying to distinguish the more subtle forms of PTLD from rejection. PTLD is rare, but, if misdiagnosed and treated with increased (rather than decreased) immunosuppression, it can quickly lead to death. The fact that both rejection and PTLD can occur simultaneously makes the challenge even greater [6]. It is hoped that newer techniques will make the diagnosis of this important condition more accurate in the future [7-9]. This figure shows an expansile plasmacytic infiltrate in a case of PTLD. However, most cases of PTLD are the result of Epstein-Barr virus-induced lymphoid proliferation.

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