A Rare Case of Metachronous Peripheral T-Cell Non-Hodgkin Lymphoma Following Epstein Barr Virus-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

Epstein Barr virus - positive (EBV+) diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS), is a newly recognized rare aggressive B- cell neoplasm with a wide morphologic spectrum. Metachronously developed B- cell and T- cell composite lymphoma (CL) is quite rare. We report a case of an elderly male who presented with enlarged abdominal lymph nodes and diagnosed as EBV+ DLBCL, NOS. He was started on chemotherapy which had to be discontinued after three cycles due to life threatening Pneumocystis carinii pneumonia and poor performance status. While on follow up, within two years, the patient presented with features of relapse. A repeat histopathological examination of the lymph node showed features of Peripheral T cell lymphoma, not otherwise specified (PTCL, NOS) and the clonality was confirmed by T- cell receptor gamma chain rearrangement assay. More studies are needed to understand the association of EBV+ DLBCL, NOS with other lymphomas.