A case of Epstein-Barr Virus-associated B-cell lymphoproliferative disorder

Background : We report a case of Epstein-Barr virus-associated B-cell lymphoproliferative disorder (EBV-LPD) with large Hodgkin/Reed-Sternberg (HRS) cell-like cells. Case : A 68-year-old Japanese man with malaise and systemic lymphadenopathy was found in lymph node cytomorphology to have large scattered atypical cells similar to HRS cells in a background of abundant mature lymphocytes and histiocytes. Histology showed feature resembling cytomorphology and a few with slightly necrotic foci. Immunohistochemistry showed large HRS cell-like cells to be positive for CD20 and CD79a, but negative for CD30 and CD15. EBER-in situ hybridization (ISH) showed nuclear positivity of large cells. The patient tested negative for antihuman immunodeficiency virus antibody and had not received solid organ or bone marrow allografts, yielding a definitive diagnosis of EBV-LPD. Conclusion : It is difficult to differentiate EBV-LPD from Hodgkin lymphoma and some non-Hodgkin variants, since large HRS-like cells are often encountered in these cases. We concluded that a detailed cytomorphological study, immunohistochemical study, a survey of pathological agents such as EBV, and adequate clinical informations are required to correctly subclassify lymphoma.