EBV Conference 2008 Guangzhou - Baylor College of Medicine

201 (RegID: 1863)
Julinor Bacani
Institution: University of Alberta
e-mail: julinor.bacani@capitalhealth.ca
CASE REPORT OF EBV POSITIVE CLASSICAL HODGKIN LYMPHOMA IN AN ADULT
WITH POLYCYSTIC KIDNEY DISEASE 15 YEARS PO
Bacani JT (UofA Hospital), Sis B(UofA Hospital), Slack GW (Cross Cancer Institute) and Ingham RJ
(UVic)
Posterabstract:
Post-transplant lymphoproliferative disorders (PTLD) are recognized as a complication of
immunosuppression and occur with a 1-8% reported incidence in solid organ transplantation recipients.
PTLD are classified into two major categories, polymorphic and monomorphic PTLD. The majority of the
monomorphic PTLD are non-Hodgkin's lymphoma (NHL) of B-cell origin. Hodgkin lymphoma (HL) is
not part of the typical spectrum of PTLD and thus rarely reported in this population as a de novo
malignancy. However, HL is recognized as part of the disease spectrum of PTLD. Epstein-Barr virus
(EBV) has been implicated in both post-transplant NHL and HL. Rarer still, specifically in the context of
polycystic kidney disease (PKD) which account for 10-15% of end stage renal patients ultimately
requiring renal transplantation, is the development of HL. Here we report the first adult case report of an
EBV-positive classical HL in an adult male with PKD. A 55-year-old man following renal transplantation
15 years ago for PKD presented with abdominal distension, B symptoms, and bipedal edema. He was also
anemic and leukopenic. Imaging showed polycystic liver and kidney, splenomegaly and significant
lymphadenopathy. A biopsy of a mobile right cervical posterior triangle lymph node showed classical HL
with readily evident classical Reed-Sternberg (RS) cells which strongly express CD15, CD30, PAX-5,
EBER and do not express CD45, CD20, ALK-1. Preferential kappa and lambda light chains expression
was not evident. Scattered reactive CD3 positive T-cells were also present. No other site of HL was
identified. He initially received a short course of valgancyclovir and subsequently underwent
chemotherapy (adriamycin, bleomycin, vinblastine and decarbazine). Follow-up 9 weeks after initial
admission and 7 weeks after chemotherapy resulted in resolution of most of his presenting symptoms and
complete resolution of mediastinal lymphadenopathy on imaging.
EBV Conference 2008 Guangzhou
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