Post-immunosuppressive and immunomodulatory therapy lymphoproliferative disorders of the gastrointestinal tract

Post-immunosuppressive and immunomodulatory therapy lymphoproliferative disorders occur during immunosuppressive treatment following allogeneic solid organ or stem cell transplant (post-transplant lymphoproliferative disorder, PTLD) or for autoimmune disorders. These disorders commonly initially present in the gastrointestinal tract, and up to 30% of patients have been shown to have GI involvement. Post-immunosuppressive therapy lymphoproliferative disorders are frequently associated with Epstein-Barr virus (EBV) and encompass a wide spectrum of morphologic and clinical presentation. EBV-negative and T-cell lymphoproliferations occur to be increasing, and a high index of suspicion is required on the part of the pathologist for timely diagnosis and treatment.