Diagnostic utility of cytology in a patient with Epstein‐Barr virus‐positive mucocutaneous ulcer in palatine tonsils: A case report

• Published in: Diagnostic cytopathology Vol. 52; no. 7; pp. E154 - E158
• Main Authors: Doi, Mieko, Hamada, Mei, Ishizawa, Keisuke, Fushimi, Naoki, Kase, Yasuhiro, Ikezono, Tetsuo, Tamaru, Jun‐ichi, Yamada, Taketo
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2024; Wiley Subscription Services, Inc
• Subjects: cytology; Epstein‐Barr virus‐positive mucocutaneous ulcer (EBVMCU); malignant lymphoma; methotrexate‐associated lymphoproliferative disorders; palatine tonsil; cytology; methotrexate‐associated lymphoproliferative disorders; Epstein‐Barr virus‐positive mucocutaneous ulcer (EBVMCU); malignant lymphoma; palatine tonsil
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.25309

Epstein‐Barr virus‐positive mucocutaneous ulcer (EBVMCU) is a newly established immunodeficiency‐related disease. Herein, we report a case of EBVMCU and focus on its cytological usefulness for diagnosis. An 82‐year‐old man manifested pharyngalgia, dysphagia, and oral pain. His medical history included rheumatoid arthritis that had been treated with methotrexate. Clinically, peritonsillar abscess was suspected, but since neoplastic lesions, including malignant lymphoma (ML), could not be excluded, a series of cytohistological examination was attempted. Despite some alarming findings (e.g., frequent mitoses), fine‐needle aspiration and touch imprint cytology consistently revealed a heterogeneous population of lymphoid and plasmacytoid cells with mild nuclear atypia. The final diagnosis of EBVMCU was established based on the permanent histologic specimen; however, retrospectively, cytology was more representative of the benign nature of the lesion than histology, helping a great deal to differentiate it from ML. Cytology can be a useful tool for the correct diagnosis of EBVMCU.