Epstein-Barr Virus Infection Mimics Malignancy in an Elderly Patient: Appearance on 18F-fluorodeoxyglucose Positron Emission Tomography–Computed Tomography

MML Tan, SJ Lu, ASW Goh

Hong Kong J Radiol 2010;13:199-201

Epstein-Barr virus infection commonly affects adolescents and young adults. We present such an infection in a 72-year-old woman, who presented with weight loss for investigation. 18F-fluorodeoxyglucose positron emission tomography-computed tomography demonstrated multiple 18F-fluorodeoxyglucose-avid lymph nodes and spleen. The initial clinical diagnosis was lymphoma, but subsequent biopsy of the lymph nodes as well as a bone marrow trephine revealed these changes to be due to Epstein-Barr virus infection. The patient was given symptomatic treatment, and follow-up 18F-fluorodeoxyglucose positron emission tomography-computed tomography revealed complete resolution of these 18F-fluorodeoxyglucose-avid lymph nodes and spleen. Our case highlights the fact that in an elderly patient, Epstein-Barr virus infection can mimic malignancy both clinically and radiologically; a biopsy and histopathological confirmation of the diagnosis should be undertaken. If the diagnosis is in doubt, follow-up 18F-fluorodeoxyglucose positron emission tomography-computed tomography should be performed.

中文摘要

一名年老病人出現擬似惡性腫瘤的EB病毒感染：在18F-脫氧葡萄糖正子攝影電腦斷層攝影上的影像

MML Tan、SJ Lu、ASW Goh

Epstein-Barr病毒（EB病毒）感染多發生在青少年或年青的成年人身上。本文報告一名受EB病毒感染的72歲女性，她病發時體重下降。18F-脫氧葡萄糖正子攝影電腦斷層攝影（18F-FDG﹣PET/CT）顯示患者在淋巴結和脾臟出現多個18F-FDG放射性增高灶，初步診斷為淋巴瘤，但其後淋巴結及骨髓切片活檢均顯示患者感染EB病毒。病人接受對症治療後，18F-FDG﹣PET/CT顯示在淋巴結和脾臟的18F-FDG放射性增高灶完全消失。本病例證明受EB病毒感染的年老患者，可能在臨床及放射影像方面，出現與惡性腫瘤極為相似的特徵。所以應為病人進行活檢，並以組織病理學結果為病人確診。如有懷疑，也應用18F-FDG﹣PET/CT為病人跟進。