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Case Reports in Pathology
Volume 2015, Article ID 513968, 6 pages
http://dx.doi.org/10.1155/2015/513968
Case Report

Clonal CD8+ T Lymphocytic Proliferation and Karyotypical Abnormalities in an EBV Associated Hemophagocytic Lymphohistiocytosis

1Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN 46202, USA
2Department of Pathology and Laboratory Medicine, Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH 45229, USA

Received 26 June 2015; Accepted 27 August 2015

Academic Editor: Dimosthenis Miliaras

Copyright © 2015 Jiehao Zhou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

EBV associated hemophagocytic lymphohistiocytosis and EBV-positive T cell lymphoproliferative disease of childhood share many histologic and clinical features, which sometimes makes it very difficult to render a definitive diagnosis. In this report, we present a 16-year-old male who developed symptoms clinically consistent with EBV associated hematophagocytic lymphohistiocytosis including fulfilling most of HLH diagnostic criteria and responding promptly to HLH targeted therapy. However, histologic and cytogenetics features of this case are very concerning for EBV-positive T cell lymphoproliferative disease of childhood. This case demonstrates an ambiguous boundary of these two disease entities and emphasizes the importance of comprehensive evaluation and clinical correlation with cases suspicious of EBV driven hemophagocytic or lymphoproliferative process.