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Reticulum-Cell Sarcoma of Host Origin Arising in a Transplanted Kidney

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Grant support: grant CA13105, U.S. Public Health Service, and a Leukemia Society Scholarship (Dr. Mitchell).

▸Requests for reprints should be addressed to Robert S. Brown, M.D., Department of Medicine, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.

New Haven, Connecticut

Ann Intern Med. 1974;80(4):459-463. doi:10.7326/0003-4819-80-4-459
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A reticulum-cell sarcoma, involving the transplanted kidney and the skin of the abdominal wall, developed 22 months after renal transplantation in a 47-year-old woman. A comparison of the malignant tumor cells with donor and recipient lymphocytes, by histocompatibility serotyping, clearly showed that the reticulum sarcoma cells were identical to the recipient's lymphocytes, distinctly different from the donor's lymphocytes, and therefore must have arisen from the host. It has been assumed that the malignant lymphomas in transplant patients have arisen de novo in the recipients, but this study confirms a host-cell etiology, despite involvement of the allograft. In-vitro studies showed lymphocyte-mediated cytotoxicity of tumor cells and the presence of "blocking factors." Immunosuppression may have encouraged origination of the tumor, but inappropriate blocking factors probably fostered its growth. In addition, viral infection with hepatitis-associated antigen (HB Ag) and subacute hepatic necrosis, with the development of tuberculin anergy, were temporally related to tumor development.





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