Endobronchial Epstein-Barr Virus-Associated Smooth Muscle Tumor in Advanced HIV Infection: A Rare Case

Area of Science:

• Oncology
• Virology
• Pulmonology

Background:

• Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) predominantly affects immunocompromised individuals, including those with advanced HIV.
• Endobronchial EBV-SMT is exceptionally rare and poses diagnostic difficulties.

Purpose of the Study:

• To report a rare case of endobronchial EBV-SMT in a patient with advanced HIV.
• To discuss diagnostic challenges and management strategies for this rare condition.

Main Methods:

• A case report of a 48-year-old woman with advanced HIV.
• Diagnostic procedures included imaging, bronchoscopy, histopathology, and Epstein-Barr virus-encoded RNA in situ hybridization.
• Treatment involved bronchoscopic resection and initiation of antiretroviral therapy.

Main Results:

• The patient presented with dyspnea due to an endobronchial mass causing lung atelectasis.
• Histopathology confirmed EBV-SMT with smooth muscle differentiation.
• Despite initial improvement, the patient experienced recurrent infections and rapid deterioration.

Conclusions:

• EBV-SMT should be considered in the differential diagnosis of endobronchial spindle cell tumors in profoundly immunocompromised patients.
• Accurate diagnosis relies on histopathological evaluation and EBV confirmation.
• Management is challenging, focusing on local control and immune reconstitution.