演題詳細

ポスター / Poster

ポスター 21 (Poster 21) :LPD/免疫不全・高齢者

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
岡 芳弘 (Yoshihiro Oka):1
1:大阪大学大学院医学系研究科 呼吸器・免疫アレルギー内科学
 
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A case of EB virus (EBV)-associated lymphoproliferative disorder with severe pharyngeal ulcer

演題番号 : PS-1-154

小倉 秀充 (Hidemi Ogura):1、岩田 知真 (Kazuma Iwata):1、内山 由理 (Yuri Uchiyama):2、齋藤 竜大 (Tatsuhiro Saito):1

1:Maebashi Red Cross Hospital, Japan、2:Saiseikai Mebashi Hospital, Gunma, Japan

 

(Introduction) We report a patient of EBV-associated lymphoproliferative disorder(EBVLPD) with severe pharyngeal ulcer. (Case) A 57-years-old man, who was diagnosed as having a rheumatoid arthritis(RA) at 54 years old, was under treatment with oral prednisolone(PSL). In April 2011, the patient developed purulent nasal discharge and nasal obstruction. In March 2012, the pharyngeal tumor was seen with ulcer and plaque, which biopsy revealed EBVLPD with CD20+,EBV+, large lymphoid cells observed scattered among reactive cells. Having a history of administration of methotrexate and PSL for RA, the patient was kept under observation discontinuing the agents. But the disease was progressing. He was admitted to our hospital in September 2012. Initially, PSL(1mg/kg) was administered to avoid making worse by chemotherapy at the ulcer lesion , but no improvement was obtained. Subsequently, he received R-CHOP therapy and the tumor size reduction was observed. Thereafter, developing severe sepsis, he had another treatment. In December 2012, he died of multi-organ failure caused by hemophagocytic syndrome. (Discussion) Cases of EBVLPD with marked ulceration of pharynx are rare. Even though the serum EBV-DNA level came to negative in the clinical course, the lesion was gradually getting worse. There have been some reports of being improved states spontaneously, but we thought that particularly in cases with ulcerating lesion of pharynx, chemotherapy should be done early after diagnosis to evade having life-threating complications.

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