Epstein‐Barr virus positive diffuse large B‐cell lymphoma presenting with vaginal sloughing and ulcerated skin nodule

Lee, Lynette Ying; Namuduri, R.; Chan, Michelle Mei Fung; Quek, Jeffrey Kim Siang; Koh, Mark Jean‐Aan

doi:10.1111/cup.13074

Cited by 4 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A cohort study among people with inflammatory bowel disease found that use of thiopurines, which include azathioprine, resulted in a multivariate-adjusted hazard ratio of greater than 5 for development of lymphoproliferative disorders [ 19 ]. Case reports have been published of diffuse large B-cell lymphoma (DLBCL) developing in the setting of azathioprine use within the gastrointestinal tract [ 20 , 21 ], the genitourinary organs [ 22 , 23 ], the central nervous system [ 24 ], and the skin [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Primary hepatic Epstein–Barr virus-positive diffuse large B-cell lymphoma associated with azathioprine immunosuppression: a case report

2023

View full text Add to dashboard Cite

Background Hepatic masses are relatively common findings, and the diagnostic approach often begins by identifying patient and mass characteristics that are risk factors for malignancy. Chronic immunosuppression is a known risk factor for various malignancies, and azathioprine in particular has been reported in association with solid and hematologic malignancies, including diffuse large B-cell lymphoma. Case presentation A 46-year-old white woman presented to clinic with several weeks of gastrointestinal symptoms and was found to have a hepatic mass on imaging. Her history was notable for neuromyelitis optica spectrum disorder on chronic immunosuppression with azathioprine. It was initially thought to be an inflammatory adenoma. On 6-month follow-up imaging, the mass had grown rapidly in size and was surgically resected. Further workup determined the mass to be an iatrogenic immunodeficiency-associated Epstein–Barr virus-positive diffuse large B-cell lymphoma confined to the liver. Azathioprine was discontinued and the patient underwent treatment with rituximab with no evidence of recurrence 2 years after the initiation of treatment. Conclusions This case report describes the first time hepatic Epstein–Barr virus-positive diffuse large B-cell lymphoma has been reported with azathioprine, which highlights the unique sequelae of chronic immunosuppression, including atypical hematologic malignancies, and the importance of considering chronic immunosuppression in the diagnostic evaluation of a hepatic mass.

show abstract