A case of age-related EBV-associated B-cell lymphoproliferative disorder metachronously showing two distinct morphologic appearances, one of a polymorphic disease resembling classical Hodgkin lymphoma, and the other of a large-cell lymphoma |
| |
Authors: | Tadashi Murase Ayumi Fujita Hironori Ueno Jae-Won Park Takahiro Yano Masahiro Hoshikawa Masayuki Takagi Shigeru Kuramochi |
| |
Institution: | (1) Department of Internal Medicine, Tokai University School of Medicine, Tokai University Hachioji Hospital, 1838, Ishikawa-machi, Hachioji Tokyo, 192-0032, Japan;(2) Department of Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan;(3) Department of Pathology, St Marianna University, School of Medicine, Kawasaki, Japan;(4) Department of Pathology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan |
| |
Abstract: | We report a case of age-related EBV-associated B-cell lymphoproliferative disorder (age-related EBV+ B-cell LPD) metachronously
showing two distinct morphologic appearances: one of a polymorphic disease resembling classical Hodgkin lymphoma (CHL), and
the other of a large-cell lymphoma. A 71-year-old man was admitted to the St. Marianna University Hospital because of fever
and generalized lymphadenopathy. Right axillary lymph node biopsy revealed mixed cellularity classical Hodgkin lymphoma (MCHL).
The patient was referred to the Tokyo Medical Center, where he was treated with chemotherapy and obtained CR. One year later,
the patient again developed fever and generalized lymphadenopathy. Biopsy of the right cervical mass revealed a diagnosis
of diffuse large B-cell lymphoma. The patient was treated with salvage chemotherapies and obtained the second CR. Two years
later, the patient developed acute myeloid leukemia (AML). Although CR was achieved with chemotherapy, AML relapsed 5 months
later and proved to be refractory. Two and a half years later, the patient developed right cervical lymph node enlargement.
The biopsy again revealed diagnosis of MCHL. The patient died 2 months later. On reviewing all of the biopsy specimens, including
the findings of immunohistochemistry and in situ hybridization, possibility of CHL was ruled out, because neoplastic giant
cells resembling Hodgkin and Reed-Sternberg (HRS) cells were positive for both Oct2 and BOB.1, which has not been reported
in CHL. Both HRS-like cells at the time of diagnosis of Hodgkin lymphoma and lymphoma cells at the time of diagnosis of non-Hodgkin
lymphoma were positive for CD20 and EBV-encoded small RNAs. This case was finally diagnosed as having age-related EBV+ B-cell
LPD. We report the case here as it underscores the difficulty in diagnosing age-related EBV+ B-cell LPDs and also suggests
an important role of EBV in the pathogenesis of lymphoid neoplasms. |
| |
Keywords: | Age-related EBV-associated B-cell lymphoproliferative disorders Classical Hodgkin lymphoma Non-Hodgkin lymphoma Epstein– Barr virus |
本文献已被 SpringerLink 等数据库收录! |
|