Primary Gastric Lymphoma Following Kidney Transplantation - 40 Years-Old Woman

This 40 year-old woman who had a renal transplantation a gastric lymphoma was detected during the 14th year post transplantation she was under immune suppression drugs using azathioprine, cyclosporine and prednisone. Endoscopic views showing deep, large irregular ulcers on lesser curvature of stomach. Multiple biopsy specimens revealed diffuse large B-cell lymphoma, which was positive for CD20 and negative for Epstein-Barr virus. Chronic immune suppression is a risk for the development of post-transplantation lymphoproliferative disorders, which are frequently caused by a B-cell dyscrasia. Patients who have undergone renal transplantation, along with recipients of other types of solid-organ transplantations, undergoing long-term immunosuppression are at high risk for the development of lymphomas. Approximately 1% of renal transplant recipients have post -transplantation lymphoproliferative disorders (PTLD) develop. The emergence of PTLD has been observed soon after transplantation followed by immunosuppression, especially with cyclosporine. In this setting, the association between Epstein-Barr virus infection and PTLD is well recognized. The pathogenesis of the Epstein Barr virus-negative, late-occurring PTLD has not been extensively investigated.