Kwun Yoojin, Hong Soo-Jong, Lee Jin Seong, Son Da Hye, Seo Jong Jin
Department of Pediatrics, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Department of Radiology, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Pediatr. 2014 Sep;57(9):420-4. doi: 10.3345/kjp.2014.57.9.420. Epub 2014 Sep 30.
The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.
爱泼斯坦-巴尔病毒（EBV）具有致癌性，可将B细胞从良性表型转变为恶性表型。EBV感染还与淋巴间质性肺炎（LIP）有关。在此，我们报告一例14岁男孩的病例，该男孩被诊断为潜伏性EBV感染并伴有潜在的LIP，且无任何相关免疫缺陷。他EBV血清学阳性已达8年。最初的临床表现为慢性呼吸道症状和反复肺炎。在接下来的2年中症状加重。原位杂交结果显示EBV阳性，从而诊断为LIP。胸腔镜肺活检结果证实了该诊断。发现阿昔洛韦治疗后获得的支气管肺泡灌洗标本的EBV滴度波动。该患者潜伏性EBV感染8年，直至因间歇性腹痛和腹胀入院。体格检查和盆腔计算机断层扫描显示肠系膜有一个大肿块。切除肿块的活检诊断为伯基特淋巴瘤（BL）。该患者接受了为期4个月的联合化疗，药物包括长春新碱、甲氨蝶呤、环磷酰胺、阿霉素和泼尼松龙。他现在已无肿瘤，LIP得到控制，正在门诊接受随访。这是韩国首例关于非免疫功能低下儿童慢性潜伏性EBV感染发展为LIP和BL的病例报告。
