Korean J Pediatr.
2014 Sep;57(9):420-424. 10.3345/kjp.2014.57.9.420.
Chronic Epstein-Barr virus infection causing both benign and malignant lymphoproliferative disorders
- Affiliations
-
- 1Department of Pediatrics, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. jjseo@amc.seoul.kr
- 2Department of Radiology, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Pathology, Asan Medical Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 1727498
- DOI: http://doi.org/10.3345/kjp.2014.57.9.420
Abstract
- The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.
MeSH Terms
-
Abdominal Pain
Acyclovir
Adolescent
Ambulatory Care Facilities
B-Lymphocytes
Biopsy
Bronchoalveolar Lavage
Burkitt Lymphoma
Child
Cyclophosphamide
Diagnosis
Doxorubicin
Drug Therapy, Combination
Epstein-Barr Virus Infections
Herpesvirus 4, Human*
Humans
In Situ Hybridization
Lip
Lung
Lung Diseases, Interstitial
Lymphoproliferative Disorders*
Male
Methotrexate
Phenotype
Physical Examination
Pneumonia
Prednisolone
Vincristine
Acyclovir
Cyclophosphamide
Doxorubicin
Methotrexate
Prednisolone
Vincristine
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