title: Secondary diffuse large B-cell lymphoma after chemotherapy for acute myeloid leukemia: looking for the unexpected diagnosis.
abstract: Development of Epstein-Barr virus (EBV) positive lymphoproliferative disorders in patients with immunosuppression has become more frequently reported. A patient with acute myeloid leukemia was treated to remission, when on follow-up 9 months after his initial diagnosis, he was noted to have a generalized rash and lymphadenopathy. Evaluation of skin and bone marrow biopsies was suggestive of a relapsed leukemia, and treatment was initiated. Fever evaluation revealed a high load of EBV in his blood. A lymph node biopsy and retrospective examination of his skin and bone marrow revealed an EBV-positive diffuse large B-cell lymphoma with no recurrence of acute myeloid leukemia. His chemotherapy-induced immunosuppression likely predisposed him to develop this EBV-positive diffuse large B-cell lymphoma. This case highlights the need to consider a broader differential and immunohistochemical profiling of these neoplasms to avoid misdiagnosing complex oncology patients.
authors.affiliation: Departments of *Dermatology, and † Pathology, University of Utah, Salt Lake City, UT.
authors.forename: Marnie R
authors.initials: MR
authors.lastname: Ririe
authors.forename: Scott R
authors.initials: SR
authors.lastname: Florell
authors.forename: Rodney R
authors.initials: RR
authors.lastname: Miles
authors.forename: Keith L
authors.initials: KL
authors.lastname: Duffy
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000276:immunology* / Q000821:virology
chemical_list: D000970:Antineoplastic Agents