Atypical lymphocytes in spinal fluid resembling posttransplant lymphoma in a cardiac transplant recipient. A case report.

The interpretation of atypical leukocytes in the cerebrospinal fluid (CSF) poses diagnostic problems. We present a case of a heart transplant patient whose CSF contained highly atypical lymphocytes that were originally interpreted as "suspicious for lymphoma." Because the patient was clinically thought to have disseminated zoster, he was treated with acyclovir, and the atypical infiltrate resolved. This case exemplifies the extreme difficulty of interpreting cerebrospinal fluid in immunosuppressed patients who are at risk of developing posttransplant lymphoproliferative disorders.