Spontaneous Regression of Diffuse Large B-Cell Lymphoma Harbouring Epstein-Barr Virus: A Case Report and Review of the Literature

Abstract

We report an elderly patient with diffuse large B cell lymphoma harbouring Epstein-Barr virus that showed spontaneous regressions with subsequent relapses three times. The patient died of aspiration pneumonia without any anti-neoplastic treatment 5 years 10 months after the initial onset of lymph node swelling. In the literature, there are several reports of aggressive non-Hodgkin's lymphoma cases that showed spontaneous regressions without relapse till the last observation. Over half of the cases were the extra-nodal type. The tendency toward regression of swollen lymph nodes detected by clinicians occurs within 2 weeks after biopsy. If the remaining lymph nodes show a tendency to decrease in size after biopsy without any anti-tumor therapies, the patient may develop spontaneous regression.

Spontaneous Remission of an Untreated, MYC and BCL2 Coexpressing, High-Grade B-Cell Lymphoma: A Case Report and Literature Review

“…Activation of antitumor immunity subsequent to local tissue injury and inflammation from a biopsy has been suggested previously in the literature, although the temporal relationship between intervention and decreasing lymph node size (as in our patient) may simply be coincidental [20, 21]. Spontaneous remission has also been frequently observed in patients with concomitant viral infections, such as human immunodeficiency virus and Epstein-Barr virus [22–24]. Still other cases support the immune system hypothesis by noting spontaneous remission of Hodgkin lymphoma after cessation of immunosuppressive therapy for autoimmune disease [25].…”

Diffuse large B-cell lymphoma with a high number of epithelioid histiocytes (lymphoepithelioid B-cell lymphoma): a study of Osaka Lymphoma Study Group

“…One of the present patients with EBVpositive DLBCL-EH showed the spontaneous regression without adjuvant therapy. Spontaneous regressions of EBVpositive DLBCL were reported previously [21,22], but their histologies were not epithelioid rich.…”

Sudden appearance and spontaneous regression of diffuse large B cell lymphoma in a man with a broken arm

“…Regressions are reported days to months after biopsy, withdrawal of immunosuppressant agents, febrile illness and bacterial infection 1 – 8 , 12 , 13. Several malignancy types, including lymphoma, may develop at the site of recent trauma 14 – 17.…”

“…Spontaneous remissions rarely occur in diffuse large B cell lymphoma (DLBCL), which is an aggressive lymphoproliferative malignancy 1 – 10. In the few reported cases “spontaneous” refers to a remission in the absence of treatment, although the clinical contexts of such remissions are rarely mentioned 7 , 8.…”