POLYMORPHIC DIFFUSE B-CELL HYPERPLASIAS AND LYMPHOMAS IN RENAL-TRANSPLANT RECIPIENTS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 41  (11) , 4262-4279
Abstract
The lymphoproliferative processes that developed in 5 renal transplant recipients were studied in an attempt to characterize and classify them morphologically. Nine surgical specimens, hematological material on all patients and autopsy specimens from 3 patients were available. Studies included conventional histopathology, evaluation of cell markers (Ig and sheep erythrocyte, complement and Fc receptors) and cytoplasmic Ig (peroxidase-antiperoxidase technique), ultrastructural examination and karyotype analysis. The lymphoid lesions shared marked cytological polymorphism (small and large cells of follicular center and medullary type) and polyclonal B-cell features, which indicated a common reactive nonneoplastic origin. Other features, such as morphological atypia of the immunoblasts, extensive necrosis, chromosomal aberrations and an incipient monoclonal component suggested the development of lymphoma in some of these lesions. In contradistinction the abundance of typical immunoblasts was a feature that seemed to correlate with the clinical activity of the disease rather than with the biological malignancy. The multiplicity of B-cell types, the presence of a follicular center cell component with diffuse distribution and the extensive necrosis in the malignant forms seem to differentiate morphologically the lymphoproliferative processes arising in transplant recipients from the hyperplasias and the lymphomas developing in immunologically normal hosts. For the former the terms of polymorphic diffuse B-cell hyperplasias and polymorphic B-cell lymphomas are proposed.