title: Epstein-Barr virus-positive mucocutaneous ulcer arising in a post-hematopoietic cell transplant patient followed by polymorphic posttransplant lymphoproliferative disorder and cytomegalovirus colitis.
abstract: Epstein-Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) is a newly described entity occurring in elderly or iatrogenically immunocompromised patients. We describe a case of EBVMCU arising in a post-hematopoietic cell transplant patient and followed by EBV-positive polymorphic posttransplant lymphoproliferative disorder (EBV+polymorphic PTLD). The patient, a 52-year-old woman, received chemotherapy and autologous peripheral blood stem cell transplantation for relapsed diffuse large B-cell lymphoma (DLBCL). She achieved complete remission and was followed up in an outpatient clinic after discharge. One year later, EBVMCU appeared in the tongue and exhibited spontaneous regression. Six months after the regression of the EBVMCU, she had EBV+polymorphic PTLD, analogous to EBV+polymorphic DLBCL. The therapy for PTLD was not effective, and the patient finally died of disease progression. This was the first case of EBVMCU characterized by both an association with autologous peripheral blood stem cell transplantation and subsequent emergence of malignant lymphoma in a patient with relapsed DLBCL.
authors: Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan; Department of Diagnostic Pathology, Konan Kosei Hospital, Konan, Japan. Electronic address: sato.akira@med.nagoya-u.ac.jp.
authors: Akira
authors: A
authors: Satou
authors: Department of Hematology and Oncology, Konan Kosei Hospital, Konan, Japan.
authors: Akio
authors: A
authors: Kohno
authors: Department of Diagnostic Pathology, Konan Kosei Hospital, Konan, Japan.
authors: Ryuichi
authors: R
authors: Fukuyama
authors: Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors: Ahmed Ali
authors: AA
authors: Elsayed
authors: Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
authors: Shigeo
authors: S
authors: Nakamura
mesh_terms: D001706:Biopsy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D018450:Disease Progression; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D017809:Fatal Outcome; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000009:adverse effects; D017403:In Situ Hybridization; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000601:surgery*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics; D012008:Recurrence; D013997:Time Factors; D014060:Tongue Diseases / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D014456:Ulcer / Q000175:diagnosis / Q000276:immunology / Q000821:virology*
chemical_list: D007166:Immunosuppressive Agents; D012367:RNA, Viral
keywords: EBV(+) mucocutaneous ulcer; EBV(+) posttransplant lymphoproliferative disorder; Hematopoietic cell transplant; Immunodeficiency