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Skip Navigation LinksHome > November 2010 - Volume 34 - Issue 11 > Anorectal Epstein-Barr Virus Infection Mimicking Hodgkin Lym...
American Journal of Surgical Pathology:
doi: 10.1097/PAS.0b013e3181eded23
Case Reports

Anorectal Epstein-Barr Virus Infection Mimicking Hodgkin Lymphoma in an Immunocompetent Man

Vasiliu, Viorel MD*; Suarez, Felipe MD; Canioni, Danielle MD*; Hermine, Olivier MD, PhD; Varet, Bruno MD; Brousse, Nicole MD*

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Abstract

Anorectal Hodgkin lymphoma (HL) is rare, mainly described in human immunodeficiency virus (HIV+) patients with exceptional cases reported in immunocompetents. We report the case of a middle age HIV male, presenting with intestinal occlusion. Rectosigmoidoscopy showed multiple anorectal nodular and ulceronecrotic masses. The biopsy specimens revealed a diffuse polymorphous inflammatory infiltrate in the lamina propria, associated with CD30+, CD20+/−, CD3-, CD15-, and ALK1- scattered large Hodgkin and/or Reed Sternberg -like cells stained by LMP1+ antibody and EBER. A diagnosis of EBV-associated atypical lymphoproliferative disease mimicking HL was made. These lesions remained stable for 2 years without treatment then disappeared leaving a mucosal scar. A later control biopsy showed a condylomatous lesion, without lymphoid lesion, suggesting a sexually acquired infection. Eight years later, the complete resolution of the lesion without any treatment is a strong argument against a malignant lymphoid process and raises doubts as to the reality of isolated anorectal HL in immunocompetent participants.

© 2010 Lippincott Williams & Wilkins, Inc.

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