Oral lichen planus (OLP) is a chronic infl ammatory disorder that aff ects the oral mucous membrane. Th e prevalence of OLP in the population is considered to be 1%-2% (1). Th e etiology of OLP is not known. Th e immune system very probably plays the primary role in the development of this disease. During the last decades, several studies have suggested that human papillomaviruses (HPVs) are involved in the development of premalignant and malignant lesions (2). Th e causal role of HPV has been reported for OLP and oral squamous cell carcinoma, but there are wide variations in disease prevalence with regard to diff erent geographic populations (3). Th e aim of this study was to determine the prevalence of HPV on the mucosa in patients with OLP and compare it with healthy mucosa.Study protocol has been approved by the local ethical committee. Written informed consent was obtained from all subjects entering the study. Patients with OLP were included based upon following criteria: clinically diagnosed OLP according to objective examination (single physician) and histologically confi rmed OLP. OLP was classifi ed according to criteria previously published by World health Organization and modifi ed by van der Meij et al. (4). Smokers and patients with alcohol abuse history were excluded from the study. Sex-and age-matched controls were chosen from individuals undergoing various dental procedures with no known mucosal disease. Native tissue samples were sent for HPV genome detection. HPV DNA was extracted from native tissue. All samples were screened for the presence of HPV DNA by PCR amplifi cation with primers GP5+/ GP6+ located within the HPV L1 gene. Th e sequences of the forward and reverse primers used were FW (GP5+): 5'-TTTGTTACTGTGGTAGATACTAC-3' and REV (GP6+): 5'-AAAAATAAACTGTAAATCATATT-3'. Th is allows the detection of 37 HPV types, specifi cally 6,11,16, 18, 26, 31, 33, 35, 39, 40, 42, 45, 51, 52, 53, 54, 55, 56, 58, 59, 61, 62, 64, 66, 67, 68, 69, 70, 71, 72, 73 (MM9), 81, 82 (MM4), 83 (MM7), 84 (MM8), IS39, and CP6108. HPV typing was performed, however, due to low amounts of DNA it was not possible to analyze the results. Chi-square and Student t-test were used for comparisons. P value <0.05 was considered statistically signifi cant. A total of 45 patients with confi rmed diagnosis of OLP were examined for HPV, of whom, 33 (73.3%) were woman and 12 (26.7%) were men. Th e mean age of the patients was 56 years (±14.96) with an overall range of 33-77 years. Th e control group consisted of 24 individuals, 19 (79.2%) were women and 5 (20.8%) were men. Th e mean age of the individuals in control group was 56.1 years (±11.41) with an overall range of 29-81 years. Th ere was no statistical signifi cance according to age (p = 0.96) and gender (p = 0.59) between OLP patients and controls. Th ere were 24 (53.3%) HPV-positive patients with OLP and 21 (46.7%) patients were HPV-negative. In the control group there were 12 sub-
W e present a case of a 43-year-old Caucasian female with acute myeloid leukaemia (AML), who developed Epstein-Barr virus (EBV) positive post-transplant lymphoproliferative disorder (PTLD) of duodenum, with plasma cell differentiation after second haematopoietic stem cell transplantation. The patient was given rituximab and CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone); however, these were only temporarily effective, and the patient passed away 36 days after PTLD was diagnosed. PTLD with plasma cell differentiation is a rare type of PTLD, and there are no strict treatment guidelines. KeywordsPlasmacytoma, post-transplant lymphoproliferative disorder, PTLD, haematopoietic stem cell transplantation, HSCT Disclosure: Jiri Hanousek, Jakub Radocha, Ondrej Soucek, Lenka Pliskova, Katerina Kamaradova, Alzbeta Zavrelova and Pavel Zak have nothing to disclose in relation to this article. No funding was received in the publication of this article.Ethics: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions, and informed consent was received from the patient involved in this case study.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. 1,2 The majority of the general population is infected by EBV during their life, but an immunocompetent host mounts a swift immune response that controls proliferation of EBV infected B-cells. EBV then resides only in resting memory B-cells in latent form. 3 The balance between latently infected B-cells and immune surveillance is disrupted after a patient receivesHSCT. An increase in the number of infected B-cells (almost always of donor origin) may develop into PTLD. [4][5][6] PTLDs are divided into three stages of evolution: early lesions, polymorphic PTLDs and monomorphic PTLDs. Monomorphic PTLDs are mostly derived from B-cells, but can also be of T-cell origin, and resemble aggressive non-Hodgkin lymphomas.5 PTLD resembling diffuse large B-cell lymphoma (DLBCL) is the most common.7 Rituximab, an anti CD20 monoclonal antibody, can be used effectively to treat them. 8,9 Other types of PTLD are rare and only 4% of them show plasma cell differentiation. 7,10 We would therefore like to present our patient with PTLD of duodenum with plasma cell differentiation. Case report
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