Ririe Marnie R, Florell Scott R, Miles Rodney R, Duffy Keith L
Departments of *Dermatology, and † Pathology, University of Utah, Salt Lake City, UT.
Am J Dermatopathol. 2014 Jul;36(7):e125-8. doi: 10.1097/DAD.0000000000000027.
Development of Epstein-Barr virus (EBV) positive lymphoproliferative disorders in patients with immunosuppression has become more frequently reported. A patient with acute myeloid leukemia was treated to remission, when on follow-up 9 months after his initial diagnosis, he was noted to have a generalized rash and lymphadenopathy. Evaluation of skin and bone marrow biopsies was suggestive of a relapsed leukemia, and treatment was initiated. Fever evaluation revealed a high load of EBV in his blood. A lymph node biopsy and retrospective examination of his skin and bone marrow revealed an EBV-positive diffuse large B-cell lymphoma with no recurrence of acute myeloid leukemia. His chemotherapy-induced immunosuppression likely predisposed him to develop this EBV-positive diffuse large B-cell lymphoma. This case highlights the need to consider a broader differential and immunohistochemical profiling of these neoplasms to avoid misdiagnosing complex oncology patients.
免疫抑制患者中爱泼斯坦-巴尔病毒（EBV）阳性淋巴增殖性疾病的报道日益增多。一名急性髓系白血病患者经治疗后缓解，在初次诊断9个月后的随访中，发现他出现全身性皮疹和淋巴结病。皮肤和骨髓活检评估提示白血病复发，遂开始治疗。发热评估显示其血液中EBV载量很高。淋巴结活检以及对其皮肤和骨髓的回顾性检查发现了一例EBV阳性弥漫性大B细胞淋巴瘤，急性髓系白血病未复发。他因化疗导致的免疫抑制可能使他易患这种EBV阳性弥漫性大B细胞淋巴瘤。该病例强调，对于这些肿瘤需要考虑更广泛的鉴别诊断和免疫组化分析，以避免误诊复杂的肿瘤患者。
