Takahama Ademar, de Lima Heliton Gustavo, Ito Fabio Augusto, Ribeiro-Silva Alfredo, León Jorge Esquiche
Professor, Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Londrina, Brazil.
Professor, Department of Oral Medicine and Pediatric Dentistry, State University of Londrina, Londrina, Brazil.
J Oral Maxillofac Surg. 2019 May;77(5):977-984. doi: 10.1016/j.joms.2018.12.035. Epub 2019 Jan 5.
Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is characterized by cutaneous and/or mucosal ulcers in patients receiving immunosuppressive medication or with age-related immunosenescence. Its microscopic appearance often leads to a diagnostic challenge, sometimes mimicking an overt lymphoma. A 47-year-old woman, with a previous diagnosis of systemic lupus erythematosus, was referred for evaluation of a gingival ulcer, present for about 2 months and located in the maxillary peri-implant mucosa around implants, resembling peri-implantitis. An incisional biopsy was performed, and the microscopic evaluation showed a polymorphic infiltrate with some Reed-Sternberg-like cells. Immunohistochemistry showed positive findings for CD20, CD30, CD45, PAX-5, MUM-1, LMP-1 and EBER1/2, establishing the diagnosis of EBVMCU. After 2 months, total regression of the lesion was noted without any intervention. We discuss the possible association between the EBVMCU and systemic lupus erythematosus; to our knowledge, this is the first report of an EBVMCU simulating peri-implantitis.
爱泼斯坦-巴尔病毒阳性黏膜皮肤溃疡（EBVMCU）的特征是，在接受免疫抑制治疗的患者或与年龄相关的免疫衰老患者中出现皮肤和/或黏膜溃疡。其显微镜下表现常常带来诊断挑战，有时会酷似明显的淋巴瘤。一名47岁女性，既往诊断为系统性红斑狼疮，因牙龈溃疡前来评估，该溃疡已存在约2个月，位于种植体周围的上颌黏膜，类似种植体周围炎。进行了切开活检，显微镜评估显示为多形性浸润，伴有一些里德-施特恩贝格样细胞。免疫组化显示CD20、CD30、CD45、PAX-5、MUM-1、LMP-1和EBER1/2呈阳性结果，确诊为EBVMCU。2个月后，病变完全消退，未进行任何干预。我们讨论了EBVMCU与系统性红斑狼疮之间可能的关联；据我们所知，这是首例模拟种植体周围炎的EBVMCU报告。
