Activated Epstein-Barr Virus Causes the Post-Transplant Lymphoproliferative Disorder in the Central Nervous System

Introduction: Post-transplant lymphoproliferative disorders (PTLD) generally result in high mortality complications because the organ recipient must remain on long-term oral immunosuppressant. It is well known that the Epstein-Barr virus (EBV) undergoes reactivation during immunosuppressive drug administration, resulting in the formation of various neoplasms. Case: A 56-year-old woman was diagnosed with primary central nervous system lymphoma (PCNSL) as PTLD. The patient had previously undergone renal transplantation 17 years earlier. The brain lesion was found to contain EBV-positive lymphocytes. Further serologic testing demonstrated elevated antibodies in the EBV lytic cycle pattern, which contained viral capsid and early antigens.Discussion: Typically, the presence of PLTD due to EBV is identified by elevated levels of EBVDNA in serum or by the detection of EBV-encoded RNA in lesions via histopathological analysis.In contradistinction to systemic lymphoproliferative diseases, PCNSL is isolated by the blood-brain barrier and resides in the central nervous system.PCNSL does not have systemic lymphoid neoplasms, which makes it difficult to detect EBVcontaining PCNSL-specific lymphocytes.Serum antibody tests against to the EBV lytic cycle for EBVassociated PCNSL would be a useful diagnostic tool.Further clinical studies and observation are required to establish standard criteria for the diagnosis.