Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma arising in patient with a history of EBV-positive mucocutaneous ulcer and EBV-positive nodal polymorphous B-lymphoproliferative disorder.
Pathol Int
; 69(1): 37-41, 2019 Jan.
Article
in En
| MEDLINE
| ID: mdl-30450620
ABSTRACT
Elderly patients with Epstein-Barr virus (EBV) infection are at increased risk for developing B-cell lymphoproliferative disorder (B-LPD) due to immunosenescence. Here, we describe a case of a 75-year-old man who developed an EBV-positive (EBV+) mucocutaneous ulcer (EBVMCU) in the gingiva with spontaneous regression. Eighteen months after regression, he had a cervical lymph node enlargement that was diagnosed as EBV+ nodal polymorphous B-LPD, Ann Arbor stage IA. Clinicians decided to observe his clinical course without any treatment. Fourteen months later, the patient developed EBV-positive diffuse large B-cell lymphoma (DLBCL), Ann Arbor stage IIA, and received six courses of age-adjusted dose chemotherapy and achieved a complete remission. No evidence of a clonal relationship was found among these three lesions by standard polymerase chain reaction (PCR) analysis for immunoglobulin heavy chain. However, they all had expression of PD-L1 in the EBV+ large B-cells and Hodgkin Reed-Sternberg-like cells. This is the first case report of a PD-L1-positive (PD-L1+) EBVMCU and the development of multiple EBV-driven B-LPDs in the setting of immunosenescence within a 32-month period.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ulcer
/
Lymphoma, Large B-Cell, Diffuse
/
Herpesvirus 4, Human
/
Epstein-Barr Virus Infections
/
B7-H1 Antigen
/
Lymphoproliferative Disorders
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
Pathol Int
Journal subject:
PATOLOGIA
Year:
2019
Document type:
Article
Affiliation country:
Japan