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Epstein-Barr Virus-Positive Diffuse Large B-cell Lymphoma Arising in Ulcerative Colitis: An Instructive Case Report
Yuichiro Hamamoto1, Saori Matsui2, Kiyotaka Okawa2
1Diagnostic Pathology, Osaka International Medical & Science Center, Osaka, JPN.
Malignant lymphoma is a rare ulcerative colitis (UC) complication. This case highlights diagnostic challenges of Epstein-Barr virus-positive diffuse large B-cell lymphoma in elderly UC patients on immunosuppressants.
Area of Science:
- Gastroenterology and Oncology
- Immunology
Background:
- Ulcerative colitis (UC) patients have a slightly increased risk of developing malignant lymphoma.
- The etiology of lymphoma in UC is not fully understood, but immunosuppression is a potential factor.
Observation:
- A challenging case of Epstein-Barr virus-positive diffuse large B-cell lymphoma (EBV+ DLBCL) in an elderly patient with a history of UC.
- The patient was treated with tacrolimus, an immunomodulator, and indigo naturalis herbal medicine.
Findings:
- The lymphoma presented diagnostic difficulties due to macroscopic similarities with inflammatory bowel disease complications.
- Epstein-Barr virus positivity was noted in the diffuse large B-cell lymphoma.
Implications:
- This case underscores the importance of vigilant surveillance for lymphoma in UC patients, especially those on immunosuppressive therapy.
- Early and accurate diagnosis of lymphoma in UC patients is crucial for appropriate management and improved outcomes.
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