LYMPHOMA IN CARDIAC ALLOTRANSPLANT RECIPIENTS

Abstract

Lymphomas arising in chronically immunosuppressed allotransplant patients were characterized. The clinical and histological features of 7 cases of nonHodgkin''s lymphoma were studied and the immunological phenotype was determined in 4 cases which developed in a series of 182 patients who underwent cardiac transplantation. Clinical features which were correlated with the development of lymphoma included patient age, pretransplant diagnosis and the number of transplants. All cases of nonHodgkin''s lymphoma presented as solitary or multiple localized extranodal lesions while none presented in lymph nodes. Extranodal sites of involvement included brain, lung and soft tissues of the thigh at the site of antilymphocyte serum injections. Histologically, 5 of 7 lymphomas were classified as high grade, large cell, immunoblastic and 2 of 7 as intermediate grade, large noncleaved cell. The immunological phenotype of the neoplasm from 4 patients was determined by reaction with Ig L and H chain reagents and monoclonal antibodies to T cell and B cell antigens. All lymphomas from 4 patients which were tested stained for Ia antigen (HLA-DR) but did not stain for Ig or the T cell antigens.