Epstein-Barr virus-negative precursor B cell lymphoblastic lymphoma after liver transplantation: a unique form of posttransplant lymphoproliferative disease

BACKGROUND: We report a liver transplant patient with Epstein-Barr virus-negative, precursor B cell lymphoblastic lymphoma diagnosed 6 months after transplantation. PATIENT: The patient was a 13-year-old boy with acute, fulminant hepatic failure of unknown etiology who underwent cadaveric liver transplantation. RESULTS: Six months after the transplant, the patient developed non-tender cervical lymphadenopathy 2 days after a reduction in prednisone dosage. The adenopathy worsened despite withdrawal of immunosuppression, and a biopsy showed precursor B cell lymphoblastic lymphoma. All investigations for Epstein-Barr virus were negative. The patient responded well to chemotherapy and is currently in complete remission 24 months after diagnosis. CONCLUSIONS: Precursor B cell lymphoblastic lymphoma has not been previously reported as a form of posttransplant lymphoproliferative disease. We discuss this unique form of posttransplant lymphoproliferative disease and briefly review the clinical and pathological spectrum of posttransplant lymphoproliferative disease.