PTLDClass1995
Posttransplant Neoplasia

PTLD Classification of 1988 (Nalesnik et al.)
Category Lymphocyte Heterogeneity (Polymorphism) Plasmacytic Cells Necrosis Underlying Architecture Clonality# Comments
Reactive Diffuse Plasma Cell Hyperplasia Minimal Marked No Intact Not determined Described, but relationship to PTLD undefined
Polymorphic PTLD Prominent Variable Variable may be prominent Disrupted* 17/31 (55%) with Monoclonal component Includes Polymorphic Hyperplasia and Lymphoma of Frizzera et al.
Minimally Polymorphic PTLD Minimal Prominent Variable Disrupted 18/22 (82%) with Monoclonal component Term not widely applied; synonymous with plasmacytoma
Monomorphic PTLD None Rare to None Variable Disrupted 5/5 (100%) Monoclonal Synonymous with non-Hodgkin's lymphomas
Notes: *Early infiltrative lesions may not have recognizable architectural destruction; #Clonal composition was based on molecular or immunoperoxidase studies in individual cases.

Reference
  • Nalesnik MA, Jaffe R, Starzl TE, Demetris AJ, Porter K, Burnham JA, Makowka L, Ho M, Locker J: The pathology of posttransplant lymphoproliferative disorders occurring in the setting of Cyclosporine A-Prednisone immunosuppression. Am J Pathol 133:173-192, 1988

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