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Epstein-Barr Virus Positive Mucocutaneous Ulcer: A Case Report
Vasantha Gali1, Jonathan S Bleeker2, Douglas Lynch3
1Baylor College of Medicine.
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.
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.
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