title: Diagnosing lymphoma in a setting with a high burden of infection: a pediatric case of Epstein-Barr virus-associated aggressive B-cell lymphoma with t(8;14) (q23;q32) and extensive necrosis mimicking tuberculosis.
abstract: The association of lymphoma with necrotic granuloma can pose diagnostic challenges and delay treatment, especially in settings with a high burden of infection. In these settings, the timely use of cytogenetic and molecular methods is most relevant. Here, we report a case of B-cell lymphoma with t (8;14) in a 5-year-old male child. The lymphoma was associated with necrotic granuloma and was initially misdiagnosed as tuberculosis. Polymerase chain reaction was used to detect clonal lymphoproliferation and to rule out Mycobacterium tuberculosis infection. Tumor cells harbored Epstein-Barr virus and expressed CD20, CD10, BCL6, and Ki67 (30%), leading to the diagnosis of B-cell lymphoma with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma.
authors: Laboratório de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil.
authors: Mário Henrique Magalhães
authors: MH
authors: Barros
authors: Unidade de Oncologia Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, PE, Brazil.
authors: Edinalva
authors: E
authors: Leite
authors: Servicio de Patologia, Laboratorio de Biologia Molecular, Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina.
authors: Paola
authors: P
authors: Chabay
authors: Unidade de Oncologia Pediátrica, Hospital Universitário Oswaldo Cruz, Universidade de Pernambuco, Recife, PE, Brazil.
authors: Vera
authors: V
authors: Morais
authors: Coordenação de Pesquisa Clínica, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil.
authors: Gustavo
authors: G
authors: Stefanoff
authors: Laboratório de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, RJ, Brazil.
authors: Rocio
authors: R
authors: Hassan
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D008297:Male; D016133:Polymerase Chain Reaction; D014376:Tuberculosis / Q000175:diagnosis*