Epstein-Barr virus-positive aggressive lymphoma as a consequence of immunosuppression after multiple salvage treatments for follicular lymphoma |
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| Authors: | Orlandi E Paulli M Viglio A Pagnucco G Riboni R Baldanti F Lazzarino M |
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| Affiliation: | Institute of Haematology, University of Pavia, and Division of Haematology, Anatomic Pathology Service, and Viral Diagnostic Service, IRCCS Policlinico S. Matteo, Pavia, University of Pavia, Italy. eorlandi@smatteo.pv.it |
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| Abstract: | We report on a patient with follicular non-Hodgkin's lymphoma (NHL) who developed a fatal high-grade Epstein-Barr virus (EBV)-positive NHL after conventional chemotherapies. The sudden onset of the high-grade lymphoma was accompanied by increasing circulating EBV genome copies and was complicated by spontaneous rupture of the spleen. Splenic tissue was diffusely infiltrated by large B cells. In situ hybridization for Epstein-Barr-encoded RNA (EBER) 1-2 was positive in 70% of cells, and molecular analysis revealed the presence of EBV DNA and a monoclonal IgH gene rearrangement. This case shows that the immunosuppression of multiple treatments may induce uncontrolled reactivation of a latent EBV infection, contributing to high-grade transformation in heavily treated lymphoma patients. |
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| Keywords: | EBV-positive lymphoma immunosuppression chemotherapy |
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