A case of Epstein?Barr virus-positive mucocutaneous ulcer of the hypopharynx: a mimicker of hypopharyngeal squamous cell carcinoma
A case of Epstein?Barr virus-positive mucocutaneous ulcer of the hypopharynx: a mimicker of hypopharyngeal squamous cell carcinoma
复制标题
爱泼斯坦·巴尔病毒阳性下咽皮肤粘膜溃疡一例：类似下咽鳞状细胞癌
DOI：
10.1007/s13691-021-00523-w
复制
发表时间：
2021
影响因子：
0.7
通讯作者：
Kobayashi Tatsushi
中科院分区：
文献类型：
--
作者：
Masuoka Sota;Hiyama Takashi;Kuno Hirofumi;Morishita Yohei;Sakashita Shingo;Kobayashi Tatsushi
EB病毒阳性皮肤粘膜溃疡（EBVMCU）是一种新的疾病，由世界卫生组织于2017年描述。它被认为是一种特殊类型的免疫缺陷相关的淋巴组织增生性疾病。由于EBVMCU患者仅表现为皮肤或粘膜溃疡，因此临床上很难将其与癌区分开来。一位72岁男性，因类风湿性关节炎服用甲氨蝶呤（MTX）（12 mg/周），因内镜检查发现左侧梨状窝溃疡性肿块，提示下咽鳞状细胞癌而被转诊至我院。对比增强计算机断层扫描和磁共振成像显示一个边界不清的肿块在左侧梨状窝没有淋巴结肿大的头部和颈部区域。对下咽部溃疡性病变进行了活检，根据组织病理学结果，怀疑淋巴组织增生性疾病。MTX停药后2周，下咽部病变消失。根据临床和组织病理学结果，患者被诊断为EBVMCU。这是第一例下咽部的EBVMCU。EBVMCU应被认为是一个鉴别诊断免疫功能低下的患者下咽粘膜溃疡没有淋巴结或器官的参与。
Epstein–Barr virus-positive mucocutaneous ulcer (EBVMCU) is a new disease, described by the World Health Organization in 2017. It has been recognized as a specific type of immunodeficiency-associated lymphoproliferative disorder. Since patients with EBVMCU present with only cutaneous or mucosal ulcers, it is difficult to clinically distinguish them from carcinoma. A 72-year-old man, who took methotrexate (MTX) (12 mg/week) for rheumatoid arthritis, was referred to our hospital because endoscopy revealed an ulcerated mass in the left pyriform sinus, suggesting hypopharyngeal squamous cell carcinoma. Contrast-enhanced computed tomography and magnetic resonance imaging revealed an ill-defined mass in the left pyriform sinus without lymphadenopathy in the head and neck region. A biopsy of the ulcerative lesion in the hypopharynx was performed, and lymphoproliferative disease was suspected, based on the histopathological findings. Two weeks after MTX withdrawal, the lesions in the hypopharynx disappeared. The patient was diagnosed with EBVMCU, based on the clinical and histopathological findings. This is the first case report of EBVMCU of the hypopharynx. EBVMCU should be considered as a differential diagnosis in immunocompromised patients with hypopharyngeal mucosal ulcers without lymph node or organ involvement.