TY - JOUR
T1 - Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma arising in patient with a history of EBV-positive mucocutaneous ulcer and EBV-positive nodal polymorphous B-lymphoproliferative disorder
AU - Daroontum, Teerada
AU - Kohno, Kei
AU - Inaguma, Yoko
AU - Okamoto, Akinao
AU - Okamoto, Masataka
AU - Kimura, Yoshihiro
AU - Nagahama, Masato
AU - Sakakibara, Ayako
AU - Satou, Akira
AU - Nakamura, Shigeo
N1 - Publisher Copyright:
© 2018 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd
PY - 2019/1
Y1 - 2019/1
N2 - Elderly patients with Epstein-Barr virus (EBV) infection are at increased risk for developing B-cell lymphoproliferative disorder (B-LPD) due to immunosenescence. Here, we describe a case of a 75-year-old man who developed an EBV-positive (EBV+) mucocutaneous ulcer (EBVMCU) in the gingiva with spontaneous regression. Eighteen months after regression, he had a cervical lymph node enlargement that was diagnosed as EBV+ nodal polymorphous B-LPD, Ann Arbor stage IA. Clinicians decided to observe his clinical course without any treatment. Fourteen months later, the patient developed EBV-positive diffuse large B-cell lymphoma (DLBCL), Ann Arbor stage IIA, and received six courses of age-adjusted dose chemotherapy and achieved a complete remission. No evidence of a clonal relationship was found among these three lesions by standard polymerase chain reaction (PCR) analysis for immunoglobulin heavy chain. However, they all had expression of PD-L1 in the EBV+ large B-cells and Hodgkin Reed-Sternberg-like cells. This is the first case report of a PD-L1-positive (PD-L1+) EBVMCU and the development of multiple EBV-driven B-LPDs in the setting of immunosenescence within a 32-month period.
AB - Elderly patients with Epstein-Barr virus (EBV) infection are at increased risk for developing B-cell lymphoproliferative disorder (B-LPD) due to immunosenescence. Here, we describe a case of a 75-year-old man who developed an EBV-positive (EBV+) mucocutaneous ulcer (EBVMCU) in the gingiva with spontaneous regression. Eighteen months after regression, he had a cervical lymph node enlargement that was diagnosed as EBV+ nodal polymorphous B-LPD, Ann Arbor stage IA. Clinicians decided to observe his clinical course without any treatment. Fourteen months later, the patient developed EBV-positive diffuse large B-cell lymphoma (DLBCL), Ann Arbor stage IIA, and received six courses of age-adjusted dose chemotherapy and achieved a complete remission. No evidence of a clonal relationship was found among these three lesions by standard polymerase chain reaction (PCR) analysis for immunoglobulin heavy chain. However, they all had expression of PD-L1 in the EBV+ large B-cells and Hodgkin Reed-Sternberg-like cells. This is the first case report of a PD-L1-positive (PD-L1+) EBVMCU and the development of multiple EBV-driven B-LPDs in the setting of immunosenescence within a 32-month period.
KW - EBV-associated B-cell lymphoproliferative disorder
KW - EBV-positive diffuse large B-cell lymphoma
KW - EBV-positive mucocutaneous ulcer
KW - EBV-positive nodal polymorphous B-LPD
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U2 - 10.1111/pin.12738
DO - 10.1111/pin.12738
M3 - Article
C2 - 30450620
AN - SCOPUS:85056736081
SN - 1320-5463
VL - 69
SP - 37
EP - 41
JO - Pathology International
JF - Pathology International
IS - 1
ER -