scholarly journals Favorable outcome of Epstein-Barr virus-associated B-cell lymphoproliferative disorder complicated by immunoglobulin G4-related disease treated with rituximab-based therapy: a case report

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Koki Ueda ◽  
Kazuhiko Ikeda ◽  
Kazuei Ogawa ◽  
Masumi Sukegawa ◽  
Takahiro Sano ◽  
...  
Keyword(s):  
Case Report ◽  
B Cell ◽  
Lymphoproliferative Disorder ◽  
Epstein Barr Virus ◽  
Favorable Outcome ◽  
Immunoglobulin G4 ◽  
Barr Virus ◽  
Related Disease ◽  
Epstein Barr

scholarly journals Case Report: Composite Angioimmunoblastic T-Cell Lymphoma and Epstein-Barr Virus-Positive B-Cell Lymphoproliferative Disorder as Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders

2020 ◽  
Vol 7 ◽  
Author(s):  
Seiji Kakiuchi ◽  
Kimikazu Yakushijin ◽  
Ikumi Takagi ◽  
Junpei Rikitake ◽  
Hiroaki Akiyama ◽  
...  
Keyword(s):  
Case Report ◽  
T Cell ◽  
B Cell ◽  
Lymphoproliferative Disorder ◽  
Epstein Barr Virus ◽  
Cell Lymphoma ◽  
Lymphoproliferative Disorders ◽  
Angioimmunoblastic T Cell Lymphoma ◽  
Barr Virus ◽  
Epstein Barr

Immunosuppressants are widely used to treat patients with rheumatoid arthritis (RA), and their adverse effects have been known to cause other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs). We report a patient with RA who had been treated with methotrexate (MTX) and tacrolimus (TAC) and who developed whole body lymphadenopathy. We simultaneously confirmed angioimmunoblastic T-cell lymphoma (AITL) through a right cervical lymph node biopsy and Epstein-Barr virus-positive B-cell lymphoproliferative disorder (EBV-positive B-LPD) through a bone marrow examination. After cessation of immunosuppressant therapy, both LPDs completely disappeared. Patients with AITL are occasionally reported to develop B-cell lymphoma through reactivation of the EBV, which leads to clonal expansion in the microenvironment. Immunohistochemistry results revealed that both LPD components were positive for EBV-encoded RNA. Moreover, in this patient, the plasma EBV DNA level was found to be high; therefore, EBV infection was a probable etiology. Synchronous coexistence of AITL and B-LPD as an OIIA-LPD has rarely been reported. This case report is the first to discuss the disappearance of both LPDs on withdrawal of immunosuppressants only. AITL occasionally accompany B-LPD; however, this composite lymphoma comprised AITL and B-LPD, and OIIA-LPDs should not be overlooked.

scholarly journals The potential usefulness of sputum cytology in the conclusive diagnosis of methotrexate-associated lymphoproliferative disorders: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1983601 ◽  
Author(s):  
Seiya Mizuguchi ◽  
Kenichi Mizutani ◽  
Manabu Yamashita ◽  
Hiroshi Minato ◽  
Sohsuke Yamada
Keyword(s):  
B Cell ◽  
Lymphoproliferative Disorder ◽  
Epstein Barr Virus ◽  
B Cell Lymphoma ◽  
Lymphoid Cells ◽  
Sputum Cytology ◽  
Barr Virus ◽  
Large B Cell Lymphoma ◽  
Epstein Barr ◽  
Conclusive Diagnosis

Background: Methotrexate has been used as an anchor drug for the treatment of rheumatoid arthritis and is considered to be a cause of methotrexate-associated lymphoproliferative disorder. Spontaneous regression can occur after withdrawal of methotrexate and may be associated with Epstein–Barr virus positivity and non-diffuse large B cell lymphoma histological type. Methotrexate-associated lymphoproliferative disorders are often diagnosed pathologically by lung biopsy. To the best of our knowledge, there have been no studies on the cytological diagnosis of methotrexate-associated lymphoproliferative disorder using sputum smears. Case: A 70-year-old man, who was diagnosed with rheumatoid arthritis 13 years previously and who had been treated with methotrexate, presented shortness of breath and productive cough. Methotrexate-associated lymphoproliferative disorder was suspected as the sputum cytology showed many atypical lymphoid cells with hyperchromatic enlarged nuclei, foamy cytoplasm and distinct nucleoli. Chest computed tomography revealed multiple nodular shadows with interstitial pneumonia in the bilateral lower lung field. A lung biopsy specimen contained atypical lymphoid cells that were immunohistochemically positive for CD20 and MUM-1, and weakly positive for bcl-6, but negative for CD3 and CD10. There were no Epstein–Barr virus-infectious lymphoid cells by ISH-EBER. He was finally diagnosed with methotrexate-associated lymphoproliferative disorder (non-germinal center B-cell-like diffuse large B cell lymphoma histological type). Most of the nodules disappeared spontaneously following the withdrawal of methotrexate. Discussion and conclusion: A cytologically conclusive diagnosis of methotrexate-associated lymphoproliferative disorder may be reached using sputum smears and clinical information.

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