A rare case of plasmacytoma-like post-transplant lymphoproliferative disorder presenting in the skin of a lung transplant patient

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Post-transplant lymphoproliferative disorder (PTLD) is a lymphoid proliferation that develops as a complication of solid organ or bone marrow transplants. Most cases usually present in the gastrointestinal tract, liver, kidney or lymph nodes. Plasmacytoma-like PTLD is an uncommon variant, and presentation in the skin is exceedingly rare. We present a case of plasmacytoma-like PTLD presenting as a leg mass in a 58-year-old male. Biopsy from the lesion exhibited atypical plasmacytoid and plasmablastic cells that showed lambda light chain restriction and stained positive for CD138 and Epstain-Bar virus early RNA by in situ hybridization. These findings were diagnostic of plasmacytoma-like PTLD. Only a few similar cases have been reported in the literature. The majority of these cases occurred in heart and kidney transplant patients. To our knowledge, this is the first reported case to occur in a lung transplant patient.

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