Pinto Sara, Naia Leanor, Ferreira Gisela, Eulálio Margarida
Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
Eur J Case Rep Intern Med. 2019 Jul 26;6(8):001077. doi: 10.12890/2019_001077. eCollection 2019.
Epstein-Barr virus (EBV) is a double-stranded virus that shows tropism for B-cell lymphocytes. EBV-infected patients usually present with tonsillitis/pharyngitis, cervical lymphadenopathy and fever, but an atypical presentation can mimic lymphoproliferative disease. We present the case of a 77-year-old woman with asthenia, fever, oral ulcers and peripheral lymphadenopathy. After extensive evaluation, including anatomopathological and immunocytochemical examination of excisional lymph node biopsy samples, it was still not clear whether the patient had EBV infection or diffuse large B-cell lymphoma. In this case report, the authors describe how it can be difficult to differentiate between two different, although related, entities, making diagnosis of lymphoma highly challenging.
Lymph node biopsy findings may result in lymphoma being misdiagnosed as acute Epstein-Barr virus infection.Immunophenotypic analysis can occasionally be insufficient to establish the clonal nature of the disease.Timely diagnosis of lymphoma is necessary so that immunochemotherapy can be initiated and clinical improvement achieved.
爱泼斯坦-巴尔病毒（EBV）是一种双链病毒，对B淋巴细胞具有嗜性。EBV感染的患者通常表现为扁桃体炎/咽炎、颈部淋巴结病和发热，但非典型表现可能类似淋巴增殖性疾病。我们报告一例77岁女性患者，有乏力、发热、口腔溃疡和外周淋巴结病。经过广泛评估，包括对切除的淋巴结活检样本进行解剖病理学和免疫细胞化学检查，仍不清楚该患者是EBV感染还是弥漫性大B细胞淋巴瘤。在本病例报告中，作者描述了区分这两种不同但相关的疾病实体是多么困难，这使得淋巴瘤的诊断极具挑战性。
淋巴结活检结果可能导致淋巴瘤被误诊为急性爱泼斯坦-巴尔病毒感染。免疫表型分析偶尔可能不足以确定疾病的克隆性质。淋巴瘤的及时诊断对于启动免疫化疗并实现临床改善至关重要。
