Pathogenesis and FDG-PET/CT findings of Epstein–Barr virus-related lymphoid neoplasms

Abstract

Epstein-Barr virus (EBV) is one of the most common viruses, infecting more than 90% of the adult population worldwide. EBV genome is detected in some lymphoid neoplasms. Not only their histopathological subtypes, but also their backgrounds and their clinical courses are variable. A number of B-cell lymphoproliferative disorders associated with the immunocompromised state are related to EBV infection. The incidences of these disorders have been increasing along with generalization of organ transplantations and use of immunosuppressive treatments. Furthermore, some EBV-positive lymphoma can also occur in immunocompetent patients. While evaluating patients with generalized lymphadenopathy of unknown cause by positron emission tomography/computed tomography with 2-deoxy-2-[F]fluoro-D-glucose (FDG-PET/CT), the possibility of lymphoid neoplasms should be considered in some patients, and a careful review of the background and previous history of the patients is necessary. In this review article, we describe the pathogenesis of EBV-related lymphoid neoplasms and then present FDG-PET/CT images of representative diseases. In addition, we also present a review of other EBV-related diseases, such as infectious mononucleosis and nasopharyngeal carcinoma.

The Role of Pre-therapeutic 18F-FDG PET/CT in Pediatric Hemophagocytic Lymphohistiocytosis With Epstein-Barr Virus Infection

“…Hence, the presence of extranodal hypermetabolic lesions, especially in multiple extranodal organs, was of great significance in the diagnosis of M-HLH. And it was consistent with previous studies, which suggested single extranodal organ involvement sometimes indicated NM-HLH (23,(26)(27)(28).…”

“…Comparing to SUV max -LN and SUV max -LN/M, the study showed that SUV max -lesions had similar AUC and higher sensitivity and accuracy in detecting M-HLH, which indicated that the addition of the metabolic information of extranodal lesions could help finding the M-HLH better. In addition, it's reported that elder children are more likely to develop M-HLH with EBV infection (28). So age was combined with the above metabolic parameters separately in the differentiation analysis in our study.…”

Chronic active Epstein-Barr virus infection of T-cell type, systemic form in an African migrant: case report and review of the literature on diagnostics standards and therapeutic options

“…The biopsies revealed the atypical T-lymphocyte population in predominantly intra- and paravascular position and positive EBER-in-situ-hybridization. The intravascular localization and the high glucose uptake in PET-CT is unusual [ 13 ], however immunohistochemistry staining and T-cell receptor clonality analysis providing a polyclonal population clearly ruled out aggressive lymphomas, including extranodal NK/T-cell lymphoma/leukemia, EBV-positive peripheral T-cell lymphoma or intravascular large B-cell lymphoma. The detected complex karyotype is rare, but has previously described in CAEBV related T-cell LPD [ 10 ] and might be a result of subclonal expansion of EBV-infected T-cells rather than infectious.…”

Case Report: Chronic Active Epstein–Barr Virus Infection With Subcutaneous Nodules and Systemic Damage

“…In many cases, it is difficult to sample tissue biopsies in the clinic; therefore, PET/CT strategies are required for selected cases. Scans investigating hypermetabolic FDG foci in the liver, spleen, and bone marrow, and also multiple FDG-avid lymph nodes and skin, are highly suggestive of EBV-associated lymphoma (14). CAEBV lesions exhibiting FDG uptake are indicative of overt lymphoma development (15).…”