title: In immunocompromised patients, Epstein-Barr virus lymphadenitis can mimic angioimmunoblastic T-cell lymphoma morphologically, immunophenotypically, and genetically: a case report and review of the literature.
abstract: The development of lymphomas and solid malignancies in association with immunosuppression is a well-documented occurrence in the medical literature. We report the case of a young man who developed progressive diffuse lymphadenopathy with associated extremely high levels of serum Epstein-Barr virus in the setting of chronic immunosuppressive treatment of glomerulonephritis. Excisional biopsy of a right inguinal node revealed a sclerosing process with the morphologic appearance of angioimmunoblastic T-cell lymphoma with a CD3(+), CD4(+) immunophenotype. In situ hybridization of Epstein-Barr virus-encoded RNA was positive. Molecular probe studies demonstrated a clonal T-cell population. Upon reduction of immunosuppression, the patient's lymphadenopathy and Epstein-Barr virus titer have resolved without recurrence over 2 years time. This case demonstrates that a benign Epstein-Barr virus-associated process can mimic angioimmunoblastic T-cell lymphoma and should be considered particularly in the setting of immunosuppression, emphasizing the need for close communication with the treating physician in the interpretation of lymph node biopsies.
authors: Department of Pathology, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35249, USA.
authors: Mark R
authors: MR
authors: Steciuk
authors: Susan
authors: S
authors: Massengill
authors: Peter M
authors: PM
authors: Banks
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D005921:Glomerulonephritis / Q000188:drug therapy / Q000276:immunology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008198:Lymph Nodes / Q000187:drug effects / Q000473:pathology; D008199:Lymphadenitis / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D016399:Lymphoma, T-Cell / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000276:immunology; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus