Wei Eric X, Silva Roberto F, Cotelingam James D, Shackelford Rodney E
Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Shreveport, LA, USA.
Case Rep Pathol. 2017;2017:8946807. doi: 10.1155/2017/8946807. Epub 2017 Oct 8.
Non-Hodgkin's lymphoma (NHL) is a common malignancy of childhood; however, a lung primary presentation is an uncommon finding, as is finding an association with the Epstein-Barr virus (EBV). We report the case of a 23-month-old female who developed EBV-associated diffuse large B-cell lymphoma (DLBCL) that was initially thought to be pneumonia. Extensive tissue necrosis, focal angioinvasion, and angiodestruction were observed. She was refractory to various therapy regimens, subsequently developed DLBCL in the central nervous system, and eventually expired. Although EBV+ DLBCL was initially considered to occur predominantly in elderly patients over 50 years of age, it is now increasingly recognized to occur in younger patients with primarily nodal involvement who have overall better prognoses. To our knowledge, this case is the first reported EBV+ DLBCL occurring in a patient below two years of age with lung involvement as the initial clinical presentation.
非霍奇金淋巴瘤（NHL）是儿童期常见的恶性肿瘤；然而，原发性肺表现并不常见，与爱泼斯坦-巴尔病毒（EBV）相关的情况也不常见。我们报告了一例23个月大的女性，她患了与EBV相关的弥漫性大B细胞淋巴瘤（DLBCL），最初被认为是肺炎。观察到广泛的组织坏死、局灶性血管侵犯和血管破坏。她对各种治疗方案均无效，随后在中枢神经系统发生了DLBCL，最终死亡。虽然EBV阳性的DLBCL最初被认为主要发生在50岁以上的老年患者中，但现在越来越多地认识到它也发生在年龄较小、主要累及淋巴结且总体预后较好的患者中。据我们所知，该病例是首例报道的以肺部受累为初始临床表现的2岁以下EBV阳性DLBCL患者。
