A Case of Exophytic Oral Lymphoma Secondary to Organ Transplantation

Abstract

Introduction: Transplant recipients have a fourfold increased risk of developing cancer owing to the immunosuppressive nature of their treatment. Post-transplant lymphoproliferative disorders (PTLD) are organ transplantation related complications. The effect of the immunosuppressive therapy is considered the most significant risk factor. Other variables, including age, transplant type, and susceptibility to Epstein-Barr virus (EBV) infection can all affect the incidence rate. Method(s): A 72-year-old male with a history of heart and kidney transplants presented with a six-month history of a 5 cm oral mass adjacent to the left mandibular molars. Radiographic imaging showed a radiolucency around the lower left second molar. Surgical removal of the involved molar teeth and incisional biopsy of left alveolar ridge showed an EBV-positive plasmablastic neoplasm consistent with plasmablastic lymphoma in the context of post-transplant immunosuppression. Result(s): Due to bleeding and aspiration risks, and the increasingly exophytic presentation of the unstable lesion, surgical excision was pursued. An excisional debulking biopsy of the floor of mouth lymphomatous lump was completed. Histology confirmed EBV-positive plasmablastic lymphoma associated with post-transplant immunosuppression. The patient received radiotherapy from the haemato-oncology team, though treatment was complicated by mucositis. Conclusion(s): PTLD, though rare, is a serious complication in transplant patients with immunosuppression-induced EBV dysregulation. Intraoral masses in transplant recipients should be biopsied promptly to assess for plasmablastic lymphoma, enabling early intervention and appropriate treatment planning.Copyright © 2025