Association of Epstein-Barr virus with polymorphic reticulosis

We report a case of polymorphic reticulosis (PR) associated with pharyngeal replication of Epstein-Barr virus (EBV). A 78-year-old man with necrotic inflammatory granulations in the nasal cavities and ulcerative tissue of the tonsils was found to have PR after an initial diagnosis of lethal midline granuloma and was found to have high antibody titers to EBV. EBV-determined nuclear antigen (EBNA) was demonstrated in pharyngeal biopsy specimens by the anti-complement immunofluorescent technique, following which dual immunofluorescence staining, EBNA and T-cell antigen analysis were performed, using a wide variety of monoclonal antibodies. All of the EBNA-positive lymphocytes in the pharyngeal biopsy specimens were found to have exclusively T-cell antigens. This case strongly suggests that some of the cases of PR related to T-cell lymphomas may be closely associated with active EBV infection.