Pulmonary Epstein-Barr virus-associated smooth muscle tumor after kidney transplantation: two case reports with review of differential diagnosis

Vol. 65 No. 1, 2024

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Xiao-yu Fu, Xia Gao, Chun-lei Zhao, Xing-feng Qi, Xiao-juan Ouyang, Ling-hua Zhu, Dong Wang, Li-juan Qu, Xian-zong Ye

Pulmonary nodules are a common complication in solid organ transplant recipients, and may have various underlying causes, with Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) being one of them. Given the rarity of this entity, we describe the diagnosis and therapeutic interventions for post-transplant EBV-SMT in two individuals. Both cases involved female patients who were diagnosed with multiple pulmonary nodules 60 months and 116 months, respectively, after receiving living-related kidney transplantation. Pathological examination revealed a spindle cell tumor, with immunophenotype and EBV in situ hybridization supporting the diagnosis of EBV-SMT. After diagnosis, these two patients underwent intervention by decreasing their intake of immunosuppressants. As of the latest follow-up, the patients lesion size remained stable, and their overall condition was favorable. We also reviewed literature about the morphological and molecular pathological features of EBV-SMT and highlighted the diagnosis and differential diagnosis of pulmonary spindle cell lesions especially in the setting of immunosuppression.

Corresponding author: Li-juan Qu, Chief Physician, MMed; e-mail: qljuan6516@sina.com; Xian-zong Ye, Associate Chief Physician, MD, PhD; e-mail: yexianzong@126.com

DOI: 10.47162/RJME.65.1.13 Download PDF
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