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Post-transplantation lymphoproliferative disorder (PTLD) has been recognised as a significant complication affecting 2% of all organ allograft recipients.1 The incidence of PTLD has increased in recent years because of the steady increase in the number of organs transplanted.1 The early diagnosis of PTLD is complicated by its wide spectrum of clinical presentations and the difficulty in distinguishing it from other more frequent complications—allograft rejection and opportunistic infection.
A 20-year-old man presented with fever, headache and cough. He was a recipient of live-related renal allograft 7 years previously, at which time he started receiving standard immunosuppressive treatment. He was found to be positive for hepatitis B s antigen and e antigen. Other systemic examinations were normal.
Laboratory tests revealed bicytopenia. Despite appropriate antibiotic coverage, the patient sustained cardiac arrest.
A complete autopsy was performed after obtaining informed consent. A …