Clinical Features of NK/T-cell EBV-associated LPD Manifested As Gastrointestinal Symptoms in Patients with Normal Immunity: a Case Report and Literature Review

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2021 Jun 11

PMID 34112087

Citations 1

Authors

Si-Zhu Wang

Ying-Huan Dai

Jie Zhang

Fang-Gen Lu

La-Mei Yan

Shan Wu

Affiliations

Soon will be listed here.

Abstract

Background: Epstein-Barr virus (EBV)-associated NK/T-cell lymphoproliferative disorder (LPD) involving the gastrointestinal tract is rarely observed in individuals with normal immunity. The atypical clinical, colonoscopic manifestations often confuse clinicians, leading to misdiagnosis and delays in the treatment.

Case Presentation: Herein, we reported on a single case of a patient with gastrointestinal symptoms. Several colonoscopies showed multiple irregular ulcerations, while biopsies showed colitis with infiltration of neutrophils or lymphocytes. After 2 months follow-up, the patient was diagnosed with the extranodal NK/T-cell lymphoma, nasal type, and was treated with thalidomide. Later on, a second check was performed on his first pathological sample. Immunohistochemistry revealed EBV associated NK/T-cell LPD.

Conclusions: Multiple, multiform, and segmental gastrointestinal ulcers should be an indication for EBV infection, regardless of the presence of fever, lymphadenopathy, and hepatosplenomegaly. If EBV-associated NK/T-cell LPD is considered, serum EBV-DNA should be measured, and the tissue obtained by biopsy should be carefully analyzed for a positive expression of the EBER marker.

Citing Articles

Impact of Epstein-Barr virus infection in patients with inflammatory bowel disease.

Zhang H, Zhao S, Cao Z Front Immunol. 2022; 13:1001055.

PMID: 36389673 PMC: 9651941. DOI: 10.3389/fimmu.2022.1001055.

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