title: Leukocytoclastic vasculitis as early manifestation of Epstein-Barr virus-positive diffuse large B-cell lymphoma of the elderly.
abstract: Extensive necrotizing vasculitis (ENV) is a rare paraneoplastic phenomenon, and the majority of cases reported are associated with hematolymphoid neoplasms. Histologically, most cases of ENV represent leukocytoclastic vasculitis (LCV). Here we report the clinicopahological features of a 68-year-old man with ENV associated to a Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, a newly recognized lymphoproliferative disorder, most likely representing a paraneoplastic manifestation. The patient was treated with standard chemotherapy regimen for malignant lymphoma. Due to the extensive involvement of the extremities by ENV, surgical debridement was not feasible and a novel therapy based on CHITOSAN apposits was initiated with overall good response and subsequent re-epithelization of the skin lesions. The patient died of sepsis secondary to a Pseudomona pneumonia 17 months after diagnosis.
authors.affiliation: Department of Anatomic Pathology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Zoroquiain
authors.forename: Sergio
authors.initials: S
authors.lastname: González
authors.forename: Montserrat
authors.initials: M
authors.lastname: Molgó
authors.forename: Alejandra
authors.initials: A
authors.lastname: Rodríguez
authors.forename: José R
authors.initials: JR
authors.lastname: Valbuena
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000627:therapeutic use; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D000069283:Rituximab; D018805:Sepsis; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone; D008775:Methylprednisolone