Epstein–Barr Virus Positive Diffuse Large B-Cell Lymphoma Transformed Into Angioimmunoblastic T-Cell Lymphoma After Treatment: A Case Report and Literature Review

Abstract

Abstract Background: Angioimmunoblastic T-cell lymphoma (AITL) is the sub-type of mature T-cell non-Hodgkin lymphoma. Compared with diffuse large B-cell lymphoma (DLBCL), AITL patients are frequently accompany with Epstein–Barr virus(EBV) infection. To date, there is no report on the subsequent development of AITL in patients with EBV-positive DLBCL. We performed a rare case of EBV-positive AITL developing one year after initial diagnosis of EBV-positive DLBCL. The patient showed poor response to the chemotherapy regimen, and poor survival.Case presentation: A 83-year-old Chinese male presented with enlarged lymph nodes in the neck and bilateral inguinal. Immunohistochemically (IHC), the atypical cells were strongly positive for CD20, CD19, PAX-5 and MUM-1, but negative for CD3, CD5, CD10, Bcl-6, CyclinD1, CD138 and TdT. Besides, in situ hybridization for EBV-encoded small RNA (EBER) staining was also strongly positive. The patient was diagnosed with EBV-positive DLBCL, and transformed to Angioimmunoblastic T-cell lymphoma one year after initial diagnosis of EBV-positive DLBCL. Unfortunately, the patient ultimately died three months after diagnosed AITL. The overall survival time of this patient is fifteen months. Conclusions: Transformed EBV-positive AITL is a rare type of lymphoma with high malignancy and a generally poor prognosis. The accurate diagnosis should be depended on immunophenotype and morphology.