Post-transplant lymphoproliferative disease and malignancy risk
Description
- Lymphoid or plasmacytic proliferation arising under therapeutic immunosuppression after solid organ or haematopoietic stem cell transplant
- Mostly B-cell, EBV-driven; a spectrum from reactive polyclonal hyperplasia to aggressive monoclonal lymphoma
WHO categories
| Category | Features |
|---|---|
| Non-destructive (plasmacytic hyperplasia, infectious-mononucleosis-like, florid follicular hyperplasia) | Polyclonal; often regresses with reduced immunosuppression alone |
| Polymorphic | Partially clonal; intermediate |
| Monomorphic | Meets criteria for a defined lymphoma - usually DLBCL; also Burkitt, plasmablastic, T/NK-cell |
| Classic Hodgkin-like | Least common |
- EBV-positive ~60-80% of early cases; EBV-negative dominates the late peak and behaves more like sporadic lymphoma
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