Ratuapli et al. Journal of Medical Case Reports 2011, 5:5 http://www.jmedicalcasereports.com/content/5/1/5 Page 5 of 8 Figure 5 T cell receptor gene rearrangement by PCR analysis showing monoclonal spike. PTLD can be categorized into three distinct groups based on the World Health Organization classification of lymphoid tissue neoplasms [6] (Table 1). The first group has diffuse B-cell hyperplasia, which is relatively benign and responds well to a reduction in immunosup- pression. The second group consists of polymorphic PTLD, which is the most common group in both the adult and pediatric populations. The third group con- sists of high-grade invasive lymphomas of either T- or B-cell monoclonality. Monomorphic T-cell PTLD is further subdivided into large cell, anaplastic or an unspecified type. While the incidence of T-cell PTLD in renal transplant patients is approximately 15%, a recent study of 21 cases of post-transplant hepatosplenic T-cell lymphoma by Tey et al. [7] reported 19 patients who underwent prior renal transplant. This and several other reports [5,7,8] appear to show increased incidence, which might be due to heightened awareness along with use of increasingly potent immunosuppressants. The etiopathogenesis of T-cell PTLD is not entirely known, although it may be similar to non-Hodgkins lymphoma (NHL) seen in the general population. While