Lymphomatoid Granulomatosis in a Renal Transplant Recipient

Abstract

Lymphomatoid granulomatosis is a multi-system disorder of high mortality and characterised by angiocentric and angiodestructive lymphoreticular proliferative and granulomatous change. A case is described of this disease occurring in a renal transplant patient. The patient underwent a rapid remission of the disease after a course of combined cytotoxic therapy and remains free of disease three years after treatment. This case is the second described renal transplant patient to develop the disease and the first to be successfully treated. It is likely that the disease originated as a consequence of immunosuppression similar to the development of lymphomas in allograft recipients.

Posttransplant diffuse large B-cell lymphoma of "lymphomatoid granulomatosis" type

“…The above features were used to diagnose this lesion as grade-III LyG, which in the WHO classification would be designated as DLBCL, LyG variant [9]. LyG has only rarely been observed as a PTLD in both solid organ [4,7,26,38] and bone marrow/stem transplant recipients [3]. In all, the morphological appearance was characteristic with a polymorphic cellular infiltrate; only in one patient, based upon clonality, was a single focus considered a malignant lymphoma [26].…”

“…The recently proposed WHO classification formally recognizes LyG-like features in a DLBCL by providing a subcategory, LyG variant of DLBCL [9]. LyG has been rarely observed in solid organ transplant recipients [4,7,26,38]. In one instance [26] a single focus of lymphoma was observed in an otherwise typical LyG infiltrate at multiple sites.…”