Jiao Hao, Zhang Yongbai, Chen Zhao, Chen Xueqi, Qiu Yongkang, Huang Wenpeng, Nong Lin, Kang Lei
Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, China.
Department of Pathology, Peking University First Hospital Beijing 100034, China.
Am J Nucl Med Mol Imaging. 2022 Aug 20;12(4):129-137. eCollection 2022.
A 13-year-old girl suffered from worsen snoring and persistent bilateral nasal congestion for one year. Paranasal sinus computed tomography (CT) and magnetic resonance imaging (MRI) found nasopharyngeal passages and sinus were occupied with soft tissues and bilateral neck enlarged lymph nodes 6 months ago. Tumor markers were normal. The titers of anti-Epstein-Barr virus (EBV) IgM, anti-EBV IgG, early antigen (EA) IgG, and Epstein-Barr nuclear antigen (EBNA) IgG increased. 2-Deoxy-2-[fluorine-18]-fluoro-D-glucose (F-FDG) positron emission tomography combined with CT (PET/CT) revealed thickened soft tissues in nasopharynx and oropharynx, enlarged multiple lymph nodes in the neck, bilateral armpits, abdominal cavity and retroperitoneum, and pelvic cavity, diffuse thickening of the gastric wall of the antrum with hypermetabolism. According to the age, situation, regions, and abnormal FDG uptake, an initial diagnosis of EBV-related lymphoma was made. However, the pathological results of the nasopharyngeal mass and the abdominal lymph node confirmed the final diagnosis of a B-cell type chronic active Epstein-Barr virus disease (CAEBV), a rare type of EBV associated lymphoproliferative disorder (LPD). After receiving adoptive immune cells therapy, the EBV load decreased. At present, the patient is being followed up.
一名13岁女孩打鼾加重且双侧持续性鼻塞1年。6个月前鼻窦计算机断层扫描（CT）和磁共振成像（MRI）发现鼻咽部通道和鼻窦被软组织占据，双侧颈部淋巴结肿大。肿瘤标志物正常。抗爱泼斯坦-巴尔病毒（EBV）IgM、抗EBV IgG、早期抗原（EA）IgG和爱泼斯坦-巴尔核抗原（EBNA）IgG滴度升高。2-脱氧-2-[氟-18]-氟-D-葡萄糖（F-FDG）正电子发射断层扫描联合CT（PET/CT）显示鼻咽部和口咽部软组织增厚，颈部、双侧腋窝、腹腔、腹膜后及盆腔多发淋巴结肿大，胃窦部胃壁弥漫性增厚伴代谢增高。根据年龄、病情、部位及FDG摄取异常情况，初步诊断为EBV相关淋巴瘤。然而，鼻咽部肿物及腹部淋巴结的病理结果确诊为B细胞型慢性活动性爱泼斯坦-巴尔病毒病（CAEBV），这是一种罕见的EBV相关淋巴增殖性疾病（LPD）。接受过继性免疫细胞治疗后，EBV载量下降。目前，该患者正在接受随访。
