title: Epstein-Barr virus-associated T-cell lymphoproliferative disorder affecting skin and lung in an elderly patient.
abstract: A 70-year-old man presented with papular skin lesions and was diagnosed with Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disorder (T-LPD). The patient showed infiltration of a large number of EBV-encoded RNA-positive T cells in the skin and lung, presence of EBV load in the peripheral blood, and expansion of clonal EBV-infected γδ T cells and CD8(+) T cells in the blood and skin, as assessed by EBV-terminal repeat Southern blot, T-cell receptor polymerase chain reaction and flow cytometric analyses. In the Japanese or East Asian fatal cases of EBV-associated T/natural killer (NK)-LPD, there are two peaks in age at death, approximately 20 years and 60 years. The former age group is associated with chronic active EBV infection (CAEBV), and the latter group typically suffers from extranodal NK/T-cell lymphoma. Our case is characterized not only by the unique skin and lung manifestations but also the late onset age of the disease, indicating that the skin manifestation of CAEBV can be seen even in elderly patients.
authors.affiliation: Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hoshino
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tatsuno
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Shimauchi
authors.forename: Satoko
authors.initials: S
authors.lastname: Okada
authors.forename: Taisuke
authors.initials: T
authors.lastname: Ito
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ono
authors.forename: Koichi
authors.initials: K
authors.lastname: Ohshima
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tokura
mesh_terms: D000368:Aged; D016516:CD4-CD8 Ratio; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008168:Lung / Q000276:immunology* / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000276:immunology / Q000473:pathology / Q000821:virology*; D008297:Male; D012867:Skin / Q000276:immunology* / Q000473:pathology; D013601:T-Lymphocytes / Q000821:virology*
keywords: Epstein-Barr virus; chronic active Epstein-Barr virus; lymphoproliferative disorder; skin; γδ T cell