European Journal of Case Reports in Internal Medicine (Jul 2019)

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: A Challenging Diagnosis

  • Sara Barbosa Pinto,
  • Leonor Naia,
  • Gisela Ferreira,
  • Margarida Eulálio

DOI
https://doi.org/10.12890/2019_001077

Abstract

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Epstein-Barr virus (EBV) is a double-stranded virus that shows tropism for B-cell lymphocytes. EBV-infected patients usually present with tonsillitis/pharyngitis, cervical lymphadenopathy and fever, but an atypical presentation can mimic lymphoproliferative disease. We present the case of a 77-year-old woman with asthenia, fever, oral ulcers and peripheral lymphadenopathy. After extensive evaluation, including anatomopathological and immunocytochemical examination of excisional lymph node biopsy samples, it was still not clear whether the patient had EBV infection or diffuse large B-cell lymphoma. In this case report, the authors describe how it can be difficult to differentiate between two different, although related, entities, making diagnosis of lymphoma highly challenging.

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