Fibrin Associated Epstein–Barr Virus Positive Large B Cell Lymphoma as a Complication of a Repaired Thoraco-abdominal Aortic Aneurysm

Abstract

WHAT THIS PAPER ADDS The case of a patient with an untoward outcome after repair of his thoraco-abdominal aneurysm is reported. He was treated for an anastomotic pseudoaneurysm and for multiple visceral aneurysms of new onset. Infection was suspected however, it could not be confirmed. Finally, the post-mortem revealed a fibrin associated EpsteineBarr virus positive diffuse large B cell lymphoma, a very rare malignancy involving the aorta. Although infection is common in patients with a bad outcome after aneurysm repair, other diagnoses must be considered. Background: Malignancies involving the aorta are extremely rare. Case report: A 62 year old man with a history of open repair of a thoracic aortic aneurysm developed new visceral aneurysms and an anastomotic pseudoaneurysm. Fludeoxyglucose positron emission tomography/ computed tomography, performed for suspicion of graft infection, found abnormal uptake around the bypass, the visceral aneurysms, and the femoral arteries. The patient was treated by embolisation of the visceral aneurysms and a thoracic endovascular aortic repair. Several bleeding complications occurred, and the patient died. Post-mortem revealed a fibrin associated EpsteineBarr virus positive diffuse large B cell lymphoma. Conclusion: Patients with aortic aneurysms can develop malignancies including fibrin associated lymphoma. Clinical manifestations may be similar to those of an infectious process; timely diagnosis is uncommon.