Figure Legends
Figure 1. Patient 1: Excisional biopsy of the lymph node involved by polymorphous Post-transplant lymphoproliferative disorder. A - B. Histomorphologic findings of the lymph node biopsy reveal effacement of the nodal architecture (A. 40x) by a mixed proliferation of lymphocytes, immunoblasts, and plasma cells (B. 400x). C - F. Immunohistochemical studies highlight mixed T-cells (C. CD3), B-cells (D. PAX5), and polytypic plasma cells (E. CD138, F. Kappa, G Lambda). EBV EBER in-situ hybridization (H) highlights scattered EBV-positive cells.
Figure 2 . Patient 1: Bone marrow showing involvement by PTLD. A. Bone marrow aspirate shows increased number of plasma cells (arrow) and large B-cells (arrowhead) (A). Immunohistochemical studies highlight both small and large B-cells (2B, CD20).
Figure 3 . Patient 1: Bone marrow is negative for involvement by PTLD. Bone marrow biopsy shows mildly hypocellular marrow for age multilineage hematopoiesis (A. 100X and B. 400X). There is no morphologic support for involvement by PTLD.
Figure 4. Conventional cytogenetics (G-banded karyotype) and fluorescence in situ hybridization (FISH) studies were performed on the lymph node involved with PTLD. A. Chromosome analysis revealed 47,XX,+3[2]/46,XX[18]. B. This finding was confirmed by internal FISH studies with a probe for the centromere of chromosome 3, which detected three copies of chromosome 3 in 8.3% (25/300) of the nuclei examined. FISH studies were performed using commercially available Vysis Centromere 3 (CEP 3) probe (Abbott Molecular, Des Plaines, IL), cut off value established for trisomy 3 is 1 percent.