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

Author:

Doi Mieko1,Hamada Mei12ORCID,Ishizawa Keisuke12,Fushimi Naoki34,Kase Yasuhiro3,Ikezono Tetsuo3,Tamaru Jun‐ichi5,Yamada Taketo12

Affiliation:

1. Department of Diagnostic Pathology Saitama Medical University Saitama Japan

2. Department of Pathology Saitama Medical University Saitama Japan

3. Department of Otorhinolaryngology Saitama Medical University Saitama Japan

4. Department of Otorhinolaryngology, Head and Neck Surgery Tsuchiura Kyodo General Hospital Ibaraki Japan

5. Department of Pathology, Saitama Medical Center Saitama Medical University Saitama Japan

Abstract

AbstractEpstein‐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.

Publisher

Wiley

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1. Methotrexate;Reactions Weekly;2024-08-10

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