Which of the following statements about posttransplantation malignancy is correct?

C. Lymphoproliferative states and B-cell lymphomas are associated with Epstein-Barr virus.

 DISCUSSION: Both naturally occurring and iatrogenic states of immune deficiency are associated with an increased rate of de novo malignancy. Transplant recipients have a rate of malignancy approximately 100 times that of the normal population. The degree of immunosuppression, rather than a specific immunosuppressive agent, appears to be responsible. Squamous and basal cell carcinomas of the skin are most common; however other tumors that are common in the general population, such as breast and colon cancers, do not appear to be increased in incidence. Lymphomas, which occur at a rate that is 350 times normal, and the lymphoproliferative states that often precede them appear to be associated with Epstein-Barr virus. Possible explanations for these high malignancy rates include defective immunosurveillance, chronic stimulation of the reticuloendothelial system by the allograft, the carcinogenic effect of immunosuppressive drugs, and viral oncogenesis.