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Case Reports in Medicine
Volume 2012 (2012), Article ID 239719, 4 pages
http://dx.doi.org/10.1155/2012/239719
Case Report

PTLD Burkitt Lymphoma in a Patient with Remote Lymphomatoid Granulomatosis

1Department of Oncology, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
2Haematology Service, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
3Institute of Pathology, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
4Neurology Service, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland

Received 17 April 2011; Revised 7 August 2011; Accepted 18 October 2011

Academic Editor: Gilles Z. Lugassy

Copyright © 2012 A. Stravodimou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posttransplant lymphoproliferative disorder (PTLD) is a potentially fatal complication of solid organ transplantation. The majority of PTLD is of B-cell origin, and 90% are associated with the Epstein-Barr virus (EBV). Lymphomatoid granulomatosis (LG) is a rare, EBV-associated systemic angiodestructive lymphoproliferative disorder, which has rarely been described in patients with renal transplantation. We report the case of a patient with renal transplantation for SLE, who presented, 9 months after renal transplantation, an EBV-associated LG limited to the intracranial structures that recovered completely after adjustment of her immunosuppressive treatment. Nine years later, she developed a second PTLD disorder with central nervous system initial manifestation. Workup revealed an EBV-positive PTLD Burkitt lymphoma, widely disseminated in most organs. In summary, the reported patient presented two lymphoproliferative disorders (LG and Burkitt's lymphoma), both with initial neurological manifestation, at 9 years interval. With careful reduction of the immunosuppression after the first manifestation and with the use of chemotherapy combined with radiotherapy after the second manifestation, our patient showed complete disappearance of neurologic symptoms and she is clinically well with good kidney function. No recurrence has been observed by radiological imaging until now.