Epstein-Barr virus-associated T-cell lymphoma: a case of eyelid swelling and intramuscular infiltration mimicking dermatomyositis.
Association with Epstein-Barr virus (EBV) infection has been noted in various types of cutaneous lymphoproliferative disorders. We report a 57-year-old Japanese woman with T-cell lymphoma mimicking dermatomyositis that was associated with chronic active EBV infection. She presented with low-grade fever, bilateral erythematous swellings on the eyelids, and necrotic papules on the face. Serum creatine kinase levels were elevated and a diffuse reticular shadow was detected in both lung fields. The infiltrate of atypical lymphocytes found in skin and muscle, which contained EBV-encoded small nuclear RNA-1 and EBV, was also detected in the CD4+ peripheral blood cells. Treatment with prednisolone resolved her lesions with no relapse for 3 years, after which there was a recurrence in her left lung. Combination chemotherapy was not effective against the lung lesion and she died with multiple organ failure 2 months after the recurrence.
Shirasaki
F
F
Department of Dermatology, Graduate School of Medical Science, School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan. shirasah@med.kanazawa-u.ac.jp
Taniuchi
K
K
Matsushita
T
T
Hamaguhi
Y
Y
Takata
M
M
Takehara
K
K
D003882:Dermatomyositis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004487:Edema / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D005141:Eyelid Diseases / Q000821:virology; D005260:Female; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000175:diagnosis* / Q000821:virology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000821:virology