Acute EBV masquerading as peripheral T-cell lymphoma
Acute EBV masquerading as peripheral T-cell lymphoma
复制标题
伪装成外周 T 细胞淋巴瘤的急性 EBV
作者：
Xiao;G. Collins;E. Soilleux;T. Eyre
EB病毒（EBV）的组织学特征很少与淋巴瘤相似。一个25岁的病人在短暂的疾病后出现自发性脾破裂。脾脏和骨髓组织的组织学评估高度提示未另行说明的外周T细胞淋巴瘤（PTCL-NOS）。T细胞受体（TCR）PCR克隆性研究显示，单克隆T细胞群同时表达TCRβ和γ，强烈提示T细胞克隆性疾病。EBV IgM阳性，IgG阴性。EBV-PCR阳性率为7.02 ×104/mL。尽管组织病理学和克隆性研究强烈提示PTCL-NOS，但仍决定观察患者，不开始多药化疗。患者情况良好，没有PTCL迹象，随后血清转化为IgG+ EB病毒。我们强调了急性EB病毒伪装成PTCL的潜在陷阱，并显示了组织病理学，血清学，分子和临床特征的多学科整合的关键作用，以避免误诊。
Histological features of Epstein-Barr virus (EBV) can rarely mimic lymphoma. A 25-year-old presented with a spontaneous splenic rupture following a short illness. Histopathology assessment of the splenic and marrow tissue was highly suggestive of peripheral T-cell lymphoma not-otherwise-specified (PTCL-NOS). T-cell receptor (TCR) PCR clonality studies revealed a monoclonal T-cell population expressing for both TCRβ and γ, strongly suggestive of a T-cell clonal disease. EBV IgM was positive and IgG negative. EBV PCR was positive (7.02 ×104/mL). Despite the strong suggestion of PTCL-NOS from histopathology and clonality studies, the decision was made to observe the patient and not start multiagent chemotherapy. The patient remained well, with no signs of PTCL and subsequently seroconverted to IgG+ EBV. We highlight the potential pitfall of acute EBV masquerading as PTCL and show the critical role of the multidisciplinary integration of histopathological, serology, molecular and clinical features to avoid misdiagnosis.