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Epstein-Barr virus mimicking lymphoma--a case report
C Epskamp1, P de Man, E J Libourel
1Department of Internal Medicine, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
The Netherlands Journal of Medicine
|November 20, 2015
Summary
This case study describes an unusual Epstein-Barr virus (EBV) infection presenting as lymphoma-like symptoms. The patient experienced spontaneous remission, highlighting the complex interplay between viral infections and lymphoid malignancies.
Area of Science:
- Oncology
- Infectious Diseases
- Hematology
Background:
- A 50-year-old male presented with non-specific symptoms including fever, myalgia, and fatigue.
- Initial investigations for infection were negative, but laboratory work-up revealed elevated liver enzymes and lactate dehydrogenase.
Observation:
- Imaging demonstrated splenomegaly and widespread lymphadenopathy (cervical, axillary, mediastinal, hilar).
- Lymph node biopsy and bone marrow biopsy diagnosed peripheral T-cell non-Hodgkin's lymphoma, not otherwise specified.
- Prior to treatment, the patient became asymptomatic with normalized lab results, and Epstein-Barr virus (EBV) polymerase chain reaction (PCR) became positive.
Findings:
- Computed tomography scan showed complete remission of lymphadenopathy and normalized spleen volume.
- Serial bone marrow analyses revealed a decreasing clonal T-cell population over one year (41% to 11%).
- This presentation suggests an extreme course of EBV infection mimicking lymphoma.
Implications:
- The case highlights a rare presentation of EBV infection with significant lymphoproliferation.
- The clinical significance of the residual small monoclonal T-cell population requires further investigation.
- This case underscores the importance of considering viral etiologies in lymphoid disorders.
