Department of Hematology, Ebina General Hospital, Japan.
Division of Hematology/Oncology, Department of Internal Medicine, Tokai University School of Medicine, Japan.
Intern Med. 2023 Sep 1;62(17):2553-2557. doi: 10.2169/internalmedicine.0539-22. Epub 2023 Feb 1.
Lymphoproliferative disorders and Epstein-Barr virus reactivation (EBV-LPDs) have various forms of onset, ranging from infectious mononucleosis-like syndrome (IM-like) to lymphoma, although whether or not IM-like progresses to lymphoma remains unclear. A 61-year-old man was diagnosed with aplastic anemia (AA). Polyclonal atypical B-lymphocytes were observed in the peripheral blood, and IM-like was diagnosed. Atypical lymphocytes disappeared, but a gastrointestinal examination revealed diffuse large B-cell lymphoma (DLBCL). Rituximab was initiated but later discontinued because of severe acute respiratory syndrome coronavirus 2 infection. Pancytopenia due to AA exacerbation recurred. The patient ultimately died of multiple organ failure due to bacterial infection.
淋巴组织增生性疾病和 EBV 再激活（EBV-LPDs）有多种发病形式，从传染性单核细胞增多症样综合征（IM 样）到淋巴瘤不等，尽管 IM 样是否进展为淋巴瘤尚不清楚。一位 61 岁男性被诊断为再生障碍性贫血（AA）。在外周血中观察到多克隆非典型 B 淋巴细胞，并诊断为 IM 样。非典型淋巴细胞消失，但胃肠检查显示弥漫性大 B 细胞淋巴瘤（DLBCL）。由于严重急性呼吸综合征冠状病毒 2 感染，开始使用利妥昔单抗，但后来停止。由于 AA 恶化导致的全血细胞减少再次发生。患者最终因细菌感染导致多器官衰竭而死亡。
