Epstein-Barr virus-associated T-cell lymphoma in an adult patient: prominent infiltrates within the liver portal area revealed by autopsy.
We herein report the case of a 67-year-old man who initially presented with fever and hepatosplenomegaly, and soon died of progressive liver failure. The bone marrow was infiltrated with tumor cells showing a variable morphology and macrophages phagocytosing blood cells. The tumor cells were CD2(+), CD3(+), CD4(-), CD8(+), CD25(+), CD56(+/-), and HLA-DR(+) and exhibited clonal cytogenetic abnormalities. Microscopic examination of the liver postmortem revealed, prominent cellular infiltrates that were confined within the portal area. The infiltrated cells were medium-sized with the CD3(+), CD4(-), CD8(+), CD56(+/-), and granzyme B(+) phenotype. In situ hybridization detected Epstein-Barr virus (EBV)-encoded RNA-positive cells in the liver and spleen as well as the bone marrow obtained before his death. These observations indicate that EBV-associated T-cell lymphoma expressing cytotoxic proteins was the underlying disorder. Prominent portal involvement was most likely responsible for the fatal clinical outcome of this patient.
Ohno
Hitoshi
H
Department of Hematology, Takeda General Hospital, 28-1 Ishida-Moriminami-cho, Fushimi-ku, Kyoto, 601-1495, Japan. hitoshi-ono@fm2.seikyou.ne.jp.
Nagata
Norikazu
N
Department of Pathology, Takeda General Hospital, Kyoto, 601-1495, Japan.
Isoda
Kotaro
K
Kyoto Byori, Kyoto, 612-8411, Japan.
D000328:Adult; D000368:Aged; D000943:Antigens, Differentiation / Q000378:metabolism; D001344:Autopsy; D020031:Epstein-Barr Virus Infections / Q000378:metabolism* / Q000473:pathology* / Q000821:virology; D017809:Fatal Outcome; D004854:Herpesvirus 4, Human / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D017114:Liver Failure, Acute / Q000378:metabolism / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000556:secondary / Q000821:virology; D016399:Lymphoma, T-Cell / Q000378:metabolism* / Q000473:pathology* / Q000821:virology; D008297:Male
D000943:Antigens, Differentiation