title: Rectal Epstein-Barr virus-positive Hodgkin's lymphoma in a patient with Crohn's disease: case report and review of the literature.
abstract: We present the case of a 35-year-old man with Crohn's disease diagnosed at the age of 27, several months after an operation for small-bowel adenocarcinoma. Seven years after the adenocarcinoma diagnosis, the patient presented with severe continuous anal pain and diarrhea. In parallel with antibiotic administration, the patient was given treatment with Infliximab, but without clinical symptom amelioration. Sigmoidoscopy and subsequent biopsies from an ulcerated rectal area supported the diagnosis of Epstein-Barr virus-positive (EBV+) primary Hodgkin's lymphoma. Infliximab administration was immediately discontinued and the patient underwent oncological follow-up and began a course of chemotherapy. Only a few cases with primary gastrointestinal Hodgkin's lymphoma in Crohn's disease patients have so far been reported, including a variety of scenarios on the causal relationship including disease duration, presence of EBV, long-term immunosuppressive treatment and, recently, anti-TNFalpha administration.
authors.affiliation: Department of Pathology, Medical School, University of Ioannina, GR-451 10 Ioannina, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Bai
authors.forename: Konstantinos H
authors.initials: KH
authors.lastname: Katsanos
authors.forename: Michael
authors.initials: M
authors.lastname: Economou
authors.forename: Sevasti
authors.initials: S
authors.lastname: Kamina
authors.forename: Christine
authors.initials: C
authors.lastname: Balli
authors.forename: Evangelos
authors.initials: E
authors.lastname: Briasoulis
authors.forename: Angelos M
authors.initials: AM
authors.lastname: Kappas
authors.forename: Niki
authors.initials: N
authors.lastname: Agnantis
authors.forename: Epameinondas V
authors.initials: EV
authors.lastname: Tsianos
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006689:Hodgkin Disease / Q000150:complications* / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents; D008297:Male; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000821:virology; D012004:Rectal Neoplasms / Q000821:virology*
chemical_list: D007166:Immunosuppressive Agents