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[Follicular splenic lymphoid hyperplasia associated with EBV infection]
B Knobel1, E Melamud, S Nofech-Moses
1Dept. of Medicine B, Edith Wolfson Medical Center, Holon.
Harefuah
|August 26, 2000
Summary
Massive splenomegaly caused by reactive lymphoid hyperplasia due to Epstein-Barr virus (EBV) infection is reported. This rare condition mimicked lymphoma, highlighting the importance of accurate diagnosis in splenomegaly cases.
Area of Science:
- Immunology
- Pathology
- Virology
Background:
- Massive splenomegaly, defined as a spleen approximately 10 times normal weight, can present diagnostic challenges.
- Secondary pancytopenia can occur in patients with splenomegaly, further complicating clinical assessment.
- Hematologic malignancies, such as lymphoma, are often suspected in cases of unexplained splenomegaly and cytopenia.
Observation:
- A 36-year-old man presented with huge splenomegaly and pancytopenia, initially suspected to be malignant lymphoma.
- Splenectomy was performed due to suspicion of hematologic malignancy and patient discomfort.
- The resected spleen weighed 250g and measured 25cm, exhibiting reactive follicular lymphoid hyperplasia.
Findings:
- Immunohistochemical staining and PCR analysis ruled out follicular lymphoma and monoclonal B cell populations.
- Findings were consistent with a reactive process secondary to Epstein-Barr virus (EBV) infection.
- EBV seroconversion indicated a primary EBV infection.
Implications:
- This case highlights a rare presentation of EBV infection causing massive splenomegaly and reactive lymphoid hyperplasia.
- Accurate differentiation between reactive hyperplasia and malignancy is crucial for appropriate patient management.
- The findings expand the known spectrum of EBV-related splenic pathology.