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Previous Volume 332:19-25 January 5, 1995 Number 1 Next

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ABSTRACT

Background Epstein–Barr virus (EBV) has been associated with nasopharyngeal carcinoma, some lymphomas, and lymphoproliferative disease after organ transplantation. Many lymphoproliferative tumors that occur after transplantation are clonal, a property that classifies them as neoplastic. Clonality can be determined by analysis of the extrachromosomal circular DNA episomes produced by EBV infection.

Methods We describe three young children in whom smooth-muscle tumors developed 18 months to 5 years after liver transplantation with immunosuppression. We examined the tumors by microscopy and with immunohistochemical studies and molecular genetic analyses of the EBV DNA.

Results The tumors were composed of spindle cells with smooth-muscle features and resembled those described in patients with the acquired immunodeficiency syndrome. Immunohistochemical analysis was negative for EBV latent membrane protein and EBV receptor (CD21), but positive for EBV nuclear antigen 2. In situ hybridization revealed nuclear EBV sequences, and molecular genetic analysis showed the EBV genome to be clonal in all three patients.

Conclusions Smooth-muscle tumors that developed after organ transplantation contained clonal EBV, suggesting that the virus has a role in the development of these neoplastic lesions.

Source Information

From the Department of Pathology, University of Pittsburgh Medical Center (E.S.L., J.L., M.N.), and the Department of Pathology (R.J., M.A., P.S.D.) and Division of Transplant Surgery (J.R., B.N., A.T.), Children's Hospital of Pittsburgh — both in Pittsburgh. Presented in part at the 82nd Meeting of the U.S. and Canadian Academy of Pathology, New Orleans, March 16, 1993.

Address reprint requests to Dr. Dickman at the Department of Pathology, Children's Hospital of Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA 15213.

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Epstein–Barr Virus in Smooth-Muscle Tumors
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