Hashimoto Akiko, Asai Satsuki, Tanaka Yasuhiro, Shinzato Isaku
Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan.
Department of Pathology, Kobe City Nishi-Kobe Medical Center, Japan.
Eur J Case Rep Intern Med. 2021 Oct 27;8(10):002533. doi: 10.12890/2021_002533. eCollection 2021.
Angioimmunoblastic T-cell lymphoma (AITL) can be complicated by Epstein-Barr virus (EBV)-positive B-cell lymphoma. B-cell lymphoma may develop simultaneously at the time of AITL diagnosis or after treatment for AITL. EBV-associated B-cell lymphoma can occur in nodal and extranodal sites. We report a case of EBV-positive diffuse large B-cell lymphoma (DLBCL) of the left adrenal gland that developed after treatment for AITL. The patient presented with systemic lymphadenopathy and biopsy of one lymph node showed AITL. A complete response (CR) was achieved after initial chemotherapy for AITL, but 9 months later the left adrenal gland was enlarged. The diagnosis of EBV-positive DLBCL was made based on the histopathological findings of the left adrenal gland biopsy. Thus, EBV-positive DLBCL developed after AITL CR was achieved. Multi-drug chemotherapy combined with rituximab was administered for adrenal DLBCL, but only a partial response was achieved. We confirmed that EBV-positive B-cell lymphoma developed after treatment for AITL. An adrenal primary is rare, and this is only the second case of EBV-positive B-cell lymphoma to be reported after treatment for AITL. Clinicians should keep in mind that when nodal and extranodal lesions are seen after AITL treatment, another biopsy should be performed for the accurate determination of whether these lesions indicate AITL relapse or new-onset EBV-positive B-cell lymphoma.
We report a case of EBV-positive B-cell lymphoma of the adrenal gland after treatment for angioimmunoblastic T-cell lymphoma (AITL)When patients present with signs and symptoms suggestive of relapse after AITL treatment, another biopsy should be performed for the accurate determination of whether these lesions indicate AITL relapse or new-onset of EBV-positive B-cell lymphoma.The involvement of extranodal sites may indicate a poor prognosis of EBV-positive B-cell lymphoma after AITL treatment.
血管免疫母细胞性T细胞淋巴瘤（AITL）可并发爱泼斯坦-巴尔病毒（EBV）阳性B细胞淋巴瘤。B细胞淋巴瘤可能在AITL诊断时或AITL治疗后同时发生。EBV相关的B细胞淋巴瘤可发生于淋巴结和结外部位。我们报告1例AITL治疗后发生的左肾上腺EBV阳性弥漫性大B细胞淋巴瘤（DLBCL）病例。患者表现为全身淋巴结肿大，1个淋巴结活检显示为AITL。AITL初始化疗后达到完全缓解（CR），但9个月后左肾上腺增大。根据左肾上腺活检的组织病理学结果诊断为EBV阳性DLBCL。因此，在AITL达到CR后发生了EBV阳性DLBCL。对肾上腺DLBCL给予多药化疗联合利妥昔单抗治疗，但仅获得部分缓解。我们证实AITL治疗后发生了EBV阳性B细胞淋巴瘤。肾上腺原发性罕见，这是AITL治疗后报道的第2例EBV阳性B细胞淋巴瘤。临床医生应牢记，AITL治疗后出现淋巴结和结外病变时，应再次进行活检，以准确判断这些病变是提示AITL复发还是新发EBV阳性B细胞淋巴瘤。
我们报告1例血管免疫母细胞性T细胞淋巴瘤（AITL）治疗后肾上腺EBV阳性B细胞淋巴瘤病例。当患者出现提示AITL治疗后复发的体征和症状时，应再次进行活检，以准确判断这些病变是提示AITL复发还是新发EBV阳性B细胞淋巴瘤。结外部位受累可能提示AITL治疗后EBV阳性B细胞淋巴瘤预后不良。
