title: Anorectal Epstein-Barr virus infection mimicking Hodgkin lymphoma in an immunocompetent man.
abstract: Anorectal Hodgkin lymphoma (HL) is rare, mainly described in human immunodeficiency virus (HIV) patients with exceptional cases reported in immunocompetents. We report the case of a middle age HIV male, presenting with intestinal occlusion. Rectosigmoidoscopy showed multiple anorectal nodular and ulceronecrotic masses. The biopsy specimens revealed a diffuse polymorphous inflammatory infiltrate in the lamina propria, associated with CD30, CD20, CD3, CD15, and ALK1 scattered large Hodgkin and/or Reed Sternberg -like cells stained by LMP1 antibody and EBER. A diagnosis of EBV-associated atypical lymphoproliferative disease mimicking HL was made. These lesions remained stable for 2 years without treatment then disappeared leaving a mucosal scar. A later control biopsy showed a condylomatous lesion, without lymphoid lesion, suggesting a sexually acquired infection. Eight years later, the complete resolution of the lesion without any treatment is a strong argument against a malignant lymphoid process and raises doubts as to the reality of isolated anorectal HL in immunocompetent participants.
authors.affiliation: Departments of Pathology, Necker-Enfants Malades Hospital and Paris-Descartes University, Paris, France.
authors.forename: Viorel
authors.initials: V
authors.lastname: Vasiliu
authors.forename: Felipe
authors.initials: F
authors.lastname: Suarez
authors.forename: Danielle
authors.initials: D
authors.lastname: Canioni
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
authors.forename: Bruno
authors.initials: B
authors.lastname: Varet
authors.forename: Nicole
authors.initials: N
authors.lastname: Brousse
mesh_terms: D001004:Anus Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000821:virology; D001706:Biopsy; D004279:DNA, Viral / Q000302:isolation & purification; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000235:genetics; D006689:Hodgkin Disease / Q000175:diagnosis*; D006801:Humans; D007121:Immunocompetence; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008232:Lymphoproliferative Disorders / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000821:virology; D008297:Male; D012002:Rectal Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000821:virology; D012075:Remission, Spontaneous; D015229:Sexually Transmitted Diseases, Viral / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D012812:Sigmoidoscopy; D013997:Time Factors
chemical_list: D004279:DNA, Viral