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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*

American Journal of Surgical Pathology: November 2010 - Volume 34 - Issue 11 - pp 1715-1719
doi: 10.1097/PAS.0b013e3181eded23
Case Reports

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.

Departments of *Pathology

Clinical Hematology, Necker-Enfants Malades Hospital and Paris-Descartes University, Paris, France

Correspondence: Nicole Brousse, MD, Service d'Anatomie Pathologique, Hôpital Necker, 149 Rue de Sèvres drawn 75743 Paris Cedex 15 France (e-mail: nicole.brousse@nck.aphp.fr).

© 2010 Lippincott Williams & Wilkins, Inc.