Posttransplant lymphoproliferative disorders (PTLD or PT-LPD) encompass a range of lymphoid hyperplasias and neoplasias that occur in approximately 2-5% of organ transplant patients and about 1% of bone marrow recipients. They have been described as "opportunistic neoplasms" which arise in part as a consequence of the immunosuppression required to prevent organ rejection. The following list summarizes features of these lesions.

• The Epstein-Barr virus is thought to be an important cofactor in the development of PTLD and is present within almost all cases
• Primary EBV infection and heavy immunosuppression are considered risk factors for PTLD
• PTLD most commonly arises within the first posttransplant year.
• The clinical presentation of PTLD is heterogeneous. It most often presents as one or more tumors
• PTLD may arise in lymphoid tissues such as tonsils or lymph nodes, but frequently arises in extranodal sites
• The organ allograft itself is often involved by PTLD
• PTLD most commonly arise from B lymphocytes. Less commonly, tumors may arise from T cells or NK cells
• The histologic spectrum of PTLD ranges from hyperplastic lesions, some of which resemble mononucleosis, to atypical lymphoid lesions, to lymphomas
• Lymphomatous PTLDs most often are of the non-Hodgkins type
• PTLD most commonly arise from recipient cells in organ transplant patients and donor cells in bone marrow recipients
• Approaches to PTLD therapy include lowering of immunosuppression, antiviral therapy, surgical support, and antilymphoma therapy
• Newer therapies for PTLD include cellular therapy
• A minority of PTLD may recur
• The long-term survival of PTLD patients is dependent upon the particular form of the disease and other factors

University of Pittsburgh.