A CASE OF EPSTEIN-BARR VIRUS-POSITIVE MUCOCUTANEOUS ULCER THAT WAS DIFFICULT TO DISTINGUISH FROM LARYNGEAL CANCER

• Published in: JIBI INKOKA TEMBO Vol. 65; no. 4; pp. 157 - 161
• Main Authors: Matsushita, Yutaka, Shimizu, Yuta
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 15.08.2022; 耳鼻咽喉科展望会
• Subjects: AIDS; EB virus-positive lymphoproliferative disorder; EB virus-positive mucocutaneous ulcer; EBウイルス陽性リンパ増殖性疾患; EBウイルス陽性粘膜皮膚潰瘍
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo.65.4_157

Epstein-Barr virus-positive mucosal skin ulcers (EBVMCU) have a relatively good prognosis among the diseases classified as EB virus-positive lymphoproliferative disorders. We experienced a case that was first diagnosed as acute epiglottitis and treated with antibacterial drugs, but the improvement was poor. An ulcerous lesion subsequently appeared on the epiglottis, and a biopsy was performed considering the possibility of a malignant tumor. Finally, we diagnosed the lesion as an EBVMCU. EBVMCU often develop with the use of immunosuppressive drugs, and most of them are therefore improved by reducing or discontinuing the drugs used. Some of them may have an underlying disease that causes immunodeficiency, such as AIDS, as in this case, and in such circumstances, treatment of the causative disease is necessary.Since it is important to distinguish intractable ulcerative lesions in the oral cavity and pharynx from head and neck cancer, histopathological examination by biopsy is critical. On the other hand, since histopathological findings are similar to malignant lymphomas, such as cHL and DLBCL that require differentiation from EBVMCU, a full medical history, including the use of immunosuppressive drugs, blood test findings and localization of lesions, is also an important indicator. In addition, infection prevention measures should be taken while paying attention to the possibility of infectious diseases at the time of examination.