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Epstein-Barr Virus Positive Mucocutaneous Ulcer: A Case Report.

Vasantha Gali¹, Jonathan S Bleeker², Douglas Lynch³

¹Baylor College of Medicine.

South Dakota Medicine : the Journal of the South Dakota State Medical Association

|July 14, 2018

Summary

Epstein-Barr virus-positive mucocutaneous ulcer (EBV-MCU) is a rare condition in immunocompromised patients. This case highlights its presentation in a renal transplant recipient, emphasizing diagnostic considerations.

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Area of Science:

Oncology
Virology
Immunology

Background:

Epstein-Barr virus (EBV) is linked to B-cell lymphoproliferative disorders.
EBV-positive mucocutaneous ulcer (EBV-MCU) is a recently identified condition in immunocompromised individuals.

Observation:

A 54-year-old renal transplant recipient presented with a year of rectal pain and bleeding post-hemorrhoidectomy.
Examination revealed a large, ulcerated rectal lesion with excoriated and granular margins.
Initial biopsy was inconclusive, necessitating a repeat examination.

Findings:

Repeat biopsy showed ulcerated squamous and colonic mucosa with a submucosal lymphoid infiltrate.
Large atypical cells within the infiltrate were positive for PAX-5 and CD30.
In situ hybridization confirmed the presence of EBV RNA in the atypical cells.

Implications:

EBV-MCU is an emerging entity in transplant patients, presenting with aggressive-appearing lesions.
Accurate diagnosis requires high suspicion and thorough histopathological examination, including EBV detection.
Awareness of EBV-MCU is crucial for appropriate management in immunocompromised populations.