Burkitt’s Lymphoma Post Renal Transplantation: PTLD.Int Survey

Posttransplant lymphoproliferative disorder (PTLD) is a well known complication of solid organ transplantation, which overwhelming evidence suggests accuses potent immunosuppression used for preventing rejection episodes as the main responsible [1-3]. The incidence of PTLD in renal transplant recipients has reportedly been including a very wide range from 0.4% upto 10% according to the demographics of the patients and therapeutic approaches of their transplant centers [4]. The histopathological and behavioral characteristics of PTLD are also very diverse between patients reported in different series, based on their demographics and disease and treatment specifications [5,6]. Lymphoproliferative disorders developing after transplantation are not usually subjected to be classified according to formal categorizations of lymphomas in nontransplant era; and instead they are generally referred as PTLD with four general subcategories: (1)early lesions; (2) polymorphic lesions; (3) monomorphic lesions; and (4) Hodgkin’s disease. However, different types of lymphomas have unequal behavior and prognosis, so it is important to define lymphoma types of PTLD lesions, like those in patients of non-transplant context. Burkitt’s lymphoma has rarely been reported as a PTLD [7]. The hallmark of Burkitt lymphoma is the t(8;14) translocation, and it is defined as an undifferentiated malignant growth of lymphoreticular cells with mild to moderate nuclear and cytoplasmic variations. Burkitt’s lymphoma is categorized as a type of mature B-cell neoplasm which encompasses an immunodeficiencyrelated subtype [8,9]. The typical presentation of Burkitt’s lymphoma includes multifocal, rapid growing of extranodal masses with a priority in the retroperitoneum and abdominal viscera. In histological evaluations, the tumor is highly active mitotically and cell nuclei appear round or slightly uniform with a prominent nuclear membrane and slight nuclear indentation [9]. In the current study, we aimed to performed a very comprehensive and thorough review of the literature to find individual cases of Burkitt’s lymphoma occurring after renal transplantation to review their clinical, pathological, and prognostic data to evaluate factors which can affect disease course and prognosis in this patient population.