Chronic Epstein-Barr virus infection causing both benign and malignant lymphoproliferative disorders

Korean Journal of Pediatrics 2014³â 57±Ç 9È£ p.420 ~ p.424

±ÇÀ¯Áø(Kwun Yoo-Jin) - University of Ulsan College of Medicine Asan Medical Center Children¡¯s Hospital Department of Pediatrics
È«¼öÁ¾(Hong Soo-Jong) - University of Ulsan College of Medicine Asan Medical Center Children¡¯s Hospital Department of Pediatrics
ÀÌÁø¼º(Lee Jin-Seong) - University of Ulsan College of Medicine Asan Medical Center Children¡¯s Hospital Department of Radiology
(Son Da-Hye) - University of Ulsan College of Medicine Asan Medical Center Children¡¯s Hospital Department of Pathology
¼­Á¾Áø(Seo Jong-JIn) - University of Ulsan College of Medicine Asan Medical Center Children¡¯s Hospital Department of Pediatrics

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.

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EBV infection, Lymphoid interstitial pneumonia, Burkitt¡¯s lymphoma
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