Article ; Online: In immunocompromised patients, Epstein-Barr virus lymphadenitis can mimic angioimmunoblastic T-cell lymphoma morphologically, immunophenotypically, and genetically: a case report and review of the literature.
2012 Volume 43, Issue 1, Page(s) 127–133
Abstract: The development of lymphomas and solid malignancies in association with immunosuppression is a well-documented occurrence in the medical literature. We report the case of a young man who developed progressive diffuse lymphadenopathy with associated ... ...
Abstract | The development of lymphomas and solid malignancies in association with immunosuppression is a well-documented occurrence in the medical literature. We report the case of a young man who developed progressive diffuse lymphadenopathy with associated extremely high levels of serum Epstein-Barr virus in the setting of chronic immunosuppressive treatment of glomerulonephritis. Excisional biopsy of a right inguinal node revealed a sclerosing process with the morphologic appearance of angioimmunoblastic T-cell lymphoma with a CD3(+), CD4(+) immunophenotype. In situ hybridization of Epstein-Barr virus-encoded RNA was positive. Molecular probe studies demonstrated a clonal T-cell population. Upon reduction of immunosuppression, the patient's lymphadenopathy and Epstein-Barr virus titer have resolved without recurrence over 2 years time. This case demonstrates that a benign Epstein-Barr virus-associated process can mimic angioimmunoblastic T-cell lymphoma and should be considered particularly in the setting of immunosuppression, emphasizing the need for close communication with the treating physician in the interpretation of lymph node biopsies. |
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MeSH term(s) | Adolescent ; Diagnosis, Differential ; Epstein-Barr Virus Infections/diagnosis ; Epstein-Barr Virus Infections/immunology ; Epstein-Barr Virus Infections/virology ; Glomerulonephritis/drug therapy ; Glomerulonephritis/immunology ; Herpesvirus 4, Human/isolation & purification ; Humans ; Immunoblastic Lymphadenopathy/diagnosis ; Immunoblastic Lymphadenopathy/immunology ; Immunoblastic Lymphadenopathy/virology ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Lymph Nodes/drug effects ; Lymph Nodes/pathology ; Lymphadenitis/diagnosis ; Lymphadenitis/immunology ; Lymphadenitis/virology ; Lymphoma, T-Cell/diagnosis ; Lymphoma, T-Cell/immunology ; Lymphoma, T-Cell/virology ; Male ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/immunology ; Tacrolimus/therapeutic use ; Treatment Outcome |
Chemical Substances | Immunosuppressive Agents ; Tacrolimus (WM0HAQ4WNM) |
Language | English |
Publishing date | 2012-01 |
Publishing country | United States |
Document type | Case Reports ; Journal Article ; Review |
ZDB-ID | 207657-3 |
ISSN | 1532-8392 ; 0046-8177 |
ISSN (online) | 1532-8392 |
ISSN | 0046-8177 |
DOI | 10.1016/j.humpath.2011.02.024 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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