A 7-year-old boy had undergone kidney transplantation for chronic renal failure secondary to bilateral renal hypoplasia. He developed acute and chronic rejection and received immunosuppressive therapy. A year later he died with EBV-associated hemophagocytic syndrome. The main pathologic findings disclosed visceral (lung and stomach) and abdominal lymph node involvement of Kaposi's sarcoma and EBV-positive immunoblasts in several organs. In the lungs and lymph nodes these had the features of polymorphous lymphoimmunoblastic lesions. Because of the peculiar distribution of Kaposi's sarcoma lesions a pathogenetic hypothesis is proposed based on the site of entry of the virus. This case contributes to expanding the relationship between Kaposi's sarcoma and kidney transplantation in the pediatric population.
Child Fatal Outcome