{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:52:50Z","timestamp":1791467570419,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post\u2010transplant lymphoproliferative disorder (PTLD) is a devastating complication following solid\u2010organ and hematopoietic stem cell transplantation. While PTLD is often effectively managed with immunotherapy or immuno\u2010chemotherapy, rare cases present in a fulminant manner and are rapidly life\u2010threatening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe a case of an Epstein\u2013Barr virus (EBV)\u2010negative 16\u2010year\u2010old who developed EBV DNAemia and rapidly fulminant monomorphic PTLD within five months of receiving a heart transplant from an EBV\u2010positive donor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\/Important Clinical Findings<\/jats:title>\n                    <jats:p>Three months after transplant the patient developed EBV DNAemia, cytopenias, and severe gastrointestinal symptoms that led to the diagnosis of monomorphic PTLD, EBV\u2010positive extranodal marginal zone lymphoma of mucosa\u2010associated lymphoid tissue (MALT lymphoma). The patient underwent immunotherapy, followed by two different immuno\u2010chemotherapy regimens, none of which slowed the rapid progression of the disease. One month after the initial diagnosis, a repeat biopsy revealed the emergence of a distinct monomorphic PTLD, EBV\u2010positive diffuse large B\u2010cell lymphoma (DLBCL). The patient died of disease 10\u2009weeks after diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The case exemplifies a fulminant case of EBV\u2010positive MALT lymphoma as a form of monomorphic PTLD in a child. The case illustrates that MALT lymphoma may have an aggressive natural history, and the apparent rapid emergence of a distinct form of PTLD reinforces the need for repeat tissue sampling upon disease relapse or when the clinical behavior does not match the expectation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70452","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:58:19Z","timestamp":1791464299000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fulminant Synchronous Epstein\u2013Barr Virus\u2014Positive\n                    <scp>MALT<\/scp>\n                    Lymphoma and Diffuse Large B\u2010Cell Lymphoma Monomorphic Post\u2010Transplant Lymphoproliferative Disorder in a Child Following Heart Transplant: A Case Report"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-1389","authenticated-orcid":false,"given":"Anna J.","family":"Elias","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology Mayo Clinic Children's  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2938-922X","authenticated-orcid":false,"given":"Daniel P.","family":"Larson","sequence":"additional","affiliation":[{"name":"Division of Hematopathology, Department of Laboratory Medicine and Pathology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2709-9023","authenticated-orcid":false,"given":"Rebecca K.","family":"Ameduri","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Mayo Clinic Children's  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0322-8882","authenticated-orcid":false,"given":"Paul J.","family":"Galardy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology Mayo Clinic Children's  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"11","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1182\/blood.2022015851","article-title":"The International Consensus Classification of Mature Lymphoid Neoplasms: A Report From the Clinical Advisory Committee","volume":"140","author":"Campo E.","year":"2022","journal-title":"Blood"},{"issue":"5","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"e20163893","DOI":"10.1542\/peds.2016-3893","article-title":"Cancer Risk After Pediatric Solid Organ Transplantation","volume":"139","author":"Yanik E. 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