Angioimmunoblastic T-cell lymphoma presenting with an acute serologic Epstein-Barr virus profile
Angioimmunoblastic T-cell lymphoma presenting with an acute serologic Epstein-Barr virus profile
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DOI：
10.4081/hr.2015.5893
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发表时间：
2015-01-01
影响因子：
0.9
通讯作者：
Dorion, Patrick
中科院分区：
文献类型：
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作者：
Beer, Timothy;Dorion, Patrick
血管免疫母细胞性T细胞淋巴瘤（AITL）是一种侵袭性外周T细胞淋巴瘤，其典型特征为表现时突出的淋巴结病和B症状、多克隆高丙种球蛋白血症、自身免疫性溶血和频繁但高度可变的Epstein-巴尔病毒（EBV）参与。淋巴结活检结果通常包括淋巴结结构消失、多形性浸润、非典型T细胞（通常为CD 4 +/CD 10 +/PD 1+）和高内皮微静脉和滤泡树突状细胞的显著增殖。然而，这种典型的病理学发现通常最初被EBV+ B-免疫母细胞的突出所掩盖，有或没有相关的外周循环EBV DNA。在这里，我们记录了第一例急性血清学EB病毒谱（VCA-IgM）的病例报告与AITL患者，我们建议临床医生保持高度怀疑AITL在适当的临床情况下，无论EB病毒相关的结果。
Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive peripheral T-cell lymphoma typically characterized by prominent lymphadenopathy and B-symptoms at the time of presentation, polyclonal hypergammaglobulinemia, autoimmune hemolysis and frequent but highly variable involvement of Epstein- Barr virus (EBV). Lymph node biopsy findings typically include effacement of nodal architecture, polymorphic infiltrate, atypical T-cells (usually CD4+/CD10+/PD1+) and prominent proliferations of high endothelial venules and follicular dendritic cells. However, this classic constellation of pathologic findings is often initially obscured by a prominence of EBV+ B-immunoblasts with or without associated peripherally circulating EBV DNA. Here we document the first reported case of an acute serologic EBV profile (VCA-IgM) in a patient with AITL, and we recommend that clinicians maintain a high index of suspicion for AITL in the appropriate clinical scenario, irrespective of Epstein-Barr related findings.