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Case Reports
. 2017 Oct;30(4):443-444.
doi: 10.1080/08998280.2017.11930222.

Epstein-Barr virus-positive diffuse large B-cell lymphoma

Stacey L Murthy  1 , Michael A Hitchcock  1 , Tiana R Endicott-Yazdani  1 , John T Watson  1 , John R Krause  1
Affiliations
Case Reports

Epstein-Barr virus-positive diffuse large B-cell lymphoma

Stacey L Murthy et al. Proc (Bayl Univ Med Cent). 2017 Oct.

Abstract

While the World Health Organization included Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) as a provisional entity of a lymphoma occurring in older individuals without any known immunodeficiency in 2008, it has since been recognized that this entity may occur in younger individuals. As a result, the 2016 revision has substituted the modifier "elderly" with "not otherwise specified" (NOS). The NOS highlights that there are more specific entities with neoplastic EBV-positive large B cells such as lymphomatoid granulomatosis. Diagnosis requires that there be no other cause of immunodeficiency and that other more specific entities with neoplastic EBV plus large B cells be excluded. We present the case of an 81-year-old woman hospitalized for generalized weakness, increasing confusion, unexplained weight loss, and intermittent fevers. Examination showed lymphadenopathy, lesions in the liver and small intestine, and a very high EBV viral load. She experienced a rapid demise and at autopsy was found to have EBV+ DLBCL, NOS.

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Figures

Figure 1.
Figure 1.
Lymph node examination at autopsy. (a) Sheets of large lymphoid cells with irregular vesicular nuclei and prominent nucleoli, H&E ×400 (b) B-cell lineage demonstrated by diffuse positive CD20 staining, ×200. (c) Epstein-Barr virus involvement demonstrated by in situ hybridization for EBER, ×200.
See this image and copyright information in PMC

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