1/19. Primary anaplastic large cell lymphoma of the adrenal gland.Primary adrenal lymphomas are rare. Most reported cases are of B-cell phenotype and follow an aggressive clinical course. We report a case of primary anaplastic large cell, CD30 adrenal lymphoma developing in a 62-year-old woman. The patient presented with fatigue and vague right upper quadrant pressure. Computed tomography revealed bilateral adrenal masses. A right adrenalectomy was performed. Histologic evaluation showed islands of large atypical cells surrounded by eosinophilic acellular material. The tumor cells stained positive for CD45, CD45RO, CD43, and CD30. Epstein-Barr virus genome was identified in tumor cells using in situ hybridization. The patient was treated with chemotherapy and a 23-month follow-up examination showed no change in the size of the opposite adrenal gland and no other evidence of lymphoma.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/19. Lymphoepithelioma-like cholangiocarcinoma: an Epstein-Barr virus-associated tumor.Epstein-Barr virus (EBV) has been linked to carcinomas of several body sites, especially of the nasopharynx, salivary gland, lung, and stomach. We present five cases of lymphoepithelioma-like cholangiocarcinoma, including one that had been previously reported. Two patients were men and three were women. Their ages ranged from 42 to 66 years. Histologically, all five tumors were composed of variable proportions of undifferentiated epithelial cells and glandular components in a lymphocyte-rich stroma. EBV was detected in all five tumors by in situ hybridization for EBER-1 in both lymphoepithelioma-like carcinoma (LELC) and glandular parts, but not in 36 cases of cholangiocarcinoma without the LELC component. Taken together, these observations indicate that lymphoepithelioma-like cholangiocarcinoma is strongly linked to EBV. The LELC type of cholangiocarcinoma, like LELC of other body sites, may be more common in areas with endemic EBV infection.- - - - - - - - - - ranking = 0.6keywords = gland (Clic here for more details about this article) |
3/19. Epstein-Barr virus-associated post-transplant lymphoproliferative disease after bone marrow transplantation mimicking graft-versus-host disease.In contrast to solid organ transplantation (Tx), the incidence of post-transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell Tx (HSCT) is generally low. This risk, however, is significantly elevated in patients receiving human leukocyte antigen (HLA) mis-matched or T-cell-depleted grafts, or after treatment for severe graft-versus-host disease (GvHD). An 18-yr-old patient with positive Epstein-Barr virus (EBV) serology received a fully matched, unmanipulated bone marrow graft from an unrelated EBV-positive donor for treatment of acute myeloid leukemia (AML) in second complete remission. GvHD prophylaxis was performed with cyclosporin A (CsA) and a short course of methotrexate. Four months after Tx, the patient developed ulcerative tonsillitis that was unresponsive to antibiotic treatment. diarrhea appearing simultaneously was interpreted as gastrointestinal GvHD and steroids were added to CsA. A few days later the patient was admitted to hospital because of generalized seizure and pneumonia. Despite reduction of immunosuppression, intensification of anti-viral treatment, and subsequent mechanical ventilation, the patient died of acute respiratory distress 6 days later. autopsy demonstrated disseminated EBV-induced, multi-nodular lymphoma infiltration of the entire colon but no signs of GvHD. Moreover, both lungs, paratracheal lymph nodes, kidneys, thyroid gland, and liver were infiltrated with large B-cell non-Hodgkin's lymphomas. This case underlines the rapid and aggressive course of EBV-induced disseminated PTLD after HSCT, initially mimicking intestinal GvHD because of massive colonic lymphoma infiltration. Tissue biopsies should be performed early for establishing correct diagnosis, thus enabling specific therapy, e.g. infusion of donor leukocytes with cytotoxic t-lymphocytes.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
4/19. Epstein-Barr virus dacryoadenitis resulting in keratoconjunctivitis sicca in a child.PURPOSE: To describe a case of severe dry eye syndrome in a child. methods: Observational case report. The authors describe a 10-year-old male with severe dry eyes who was profoundly disabled by pain and photophobia despite aggressive conventional therapy. Lacrimal gland histology was consistent with the primary Sjogren syndrome, and serologic and immunohistologic evidence supported the hypothesis of Epstein-Barr virus causality. RESULTS: Treatment with systemic acyclovir and cyclosporin A resulted in dramatic and rapid reversal of the profound sicca syndrome and enabled the patient to resume his normal activities. CONCLUSION: Epstein-Barr virus dacryoadenitis should be considered in the differential diagnosis of keratoconjunctivitis sicca in children. Epstein-Barr virus can cause keratoconjunctivitis sicca, which can be treated successfully with acyclovir therapy in addition to suppression of the inflammatory response.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
5/19. Malignant lymphoepithelial lesion of the parotid gland: a case report and review of the literature.Malignant lymphoepithelial lesions are rare tumors of the major salivary glands. They most often occur in Asians and greenland Eskimos and are strongly associated with Epstein-Barr virus infection. We report a case of a malignant lymphoepithelial lesion of the parotid gland that developed in an Italian-American woman whose serology was positive for Epstein-Barr virus antibody. The patient underwent a left total parotidectomy and upper neck dissection, followed by radiation therapy. At the 2-year follow-up, she remained free of disease.- - - - - - - - - - ranking = 1.2keywords = gland (Clic here for more details about this article) |
6/19. Lymphoepithelioma-like carcinoma of the parotid gland in a patient with rheumatoid arthritis.Lymphoepithelioma-like carcinoma (LELC) is an Epstein-Barr virus (EBV) related malignancy. It is not a common condition and is usually found in the head and neck region. We describe the development of LELC involving the parotid gland in a patient with rheumatoid arthritis (RA) who had been receiving long-term azathioprine. A brief review is also made on the clinical presentation and histological features of LELC and the association of RA with EBV related diseases. The latter may be attributed to an increase in risk of malignancy associated with RA or as a result of the long-term immunosuppressive used.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
7/19. EBV-positive lymphoepithelial carcinoma of salivary gland in a woman of a non-endemic area--a case report.Lymphoepithelial carcinoma of the salivary glands is a very rare malignancy comprising not more than 0.4% of all salivary gland neoplasms in the non-endemic areas. In contrast it is much more frequent among native Greenlanders, North American Inuit (Eskimo) and Southern Chinese people living in hong kong. We report a case of a 74-year-old woman of Polish origin diagnosed with a lymphoepithelial carcinoma of the right parotid gland. The neoplastic cells were negative for EBV latent membrane protein (LMP-1), but in situ hybridisation for EBV mRNA (EBER) demonstrated positivity in almost all epithelial cells. No signs of EBV infection were found in the reactive lymphocytic component. The patient was treated with radiotherapy.- - - - - - - - - - ranking = 1.4keywords = gland (Clic here for more details about this article) |
8/19. Bilateral primary malignant lymphoma of the breast during pregnancy.The authors report a case of bilateral primary malignant lymphoma of the breast presenting during pregnancy in a 24-year-old woman. After the delivery of a healthy premature infant by Caesarean section, polychemotherapy was employed. The efficacy of the treatment could not be evaluated since the patient died within a very short period of time. autopsy and histological examination revealed infiltration of Burkitt-type lymphoma in the breast, ovary, brain, liver, kidney, adrenal gland, pancreas, stomach, bone marrow and myocardium.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
9/19. Nodal presentation of nasal-type NK/T-cell lymphoma. Report of two cases with fine needle aspiration cytology findings.BACKGROUND: Epstein-Barr virus (EBV)-associated NK/T-cell lymphoma typically occurs in extranodal sites, such as nasal cavity, nasopharynx, gastrointestinal tract, skin, testis and salivary gland. Secondary lymph node involvement is rarely encountered until late in the disease course. The fine needle aspiration cytology of NK/T-cell lymphoma with a nodal presentation has not been described before. CASES: Two cases of nasal-type (extranasal) NK/T-cell lymphoma with a nodal presentation were seen at Pamela Youde Nethersole Eastern Hospital, hong kong. Both patients presented with submandibular lymph node enlargement but unremarkable peripheral blood and bone marrow findings. Fine needle aspiration cytology was available in both cases, showing a heterogeneous population of small to medium-sized lymphoid cells, follicular center cells, plasma cells, eosinophils and some histiocytes. The medium-sized lymphoid cells showed readily discernible nuclear atypia with an irregular nuclear outline. Cell block sections revealed occasional lymphoid cells with pleomorphic nuclei. Immunocytochemical study confirmed the presence of CD56-positive lymphoma cells. in situ hybridization for EBV-encoded rna also revealed positive nuclear signals. Histologic examination of the surgical biopsies showed interfollicular expansion by malignant lymphoid cells. Immunoglobulin heavy chain gene and T-cell receptor gene rearrangement studies demonstrated a germline pattern, confirming the putative NK (natural killer cell), non-B and non-T lineage of the lymphoma cells. CONCLUSION: Nodal presentation of NK/T-cell lymphoma, though rare, is diagnosable on the basis of fine needle aspiration biopsy alone, especially in view of its distinctive immunophenotype and EBV association. Recognition of the subtle but definite cytologic atypia of malignant lymphoid cells and presence of an appropriate background (including more eosinophils than usual), together with proper application of ancillary techniques, is crucial to arriving at a correct diagnosis.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
10/19. CD4 T-lymphocyte-induced Epstein-Barr virus reactivation in a patient with severe hypersensitivity to mosquito bites and Epstein-Barr virus-infected NK cell lymphocytosis.BACKGROUND: Natural killer (NK) cell lymphocytosis associated with Epstein-Barr virus (EBV) infection often shows severe hypersensitivity to mosquito bites (HMB) characterized by intense local skin reactions and systemic symptoms such as high fever, lymphadenopathy, and hepatosplenomegaly. However, the induction mechanism of HMB is still unclear. OBSERVATIONS: We investigated a typical case of HMB with EBV-positive NK cell lymphocytosis. CD4 T cells dominantly infiltrated the site of the mosquito bite, while EBV-positive cells were few in comparison. CD4 T cells, but not CD8 T cells or NK cells, responded to the mosquito salivary gland extracts. Interestingly, coculturing of the NK cells and CD4 T cells activated by mosquito extracts induced expression of EBV lytic-cycle proteins in the NK cells. Furthermore, the expression of BZLF1, a viral lytic-cycle transactivator, was detectable at the skin lesion induced by scratch patch testing with mosquito extract. The EBV dna copy number levels in the plasma were elevated in systemic HMB symptoms compared with the normal condition. CONCLUSIONS: CD4 T cells are important for the primary skin reaction to mosquito bites and might play a key role in reactivation of latent EBV infection in NK cells. This viral reactivation contributed to the pathogenesis of the infectious mononucleosis-like systemic symptoms of HMB in our present case.- - - - - - - - - - ranking = 0.2keywords = gland (Clic here for more details about this article) |
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