Complex interplay of Epstein-Barr virus-associated lymphoproliferative disorder, angioimmunoblastic T-cell lymphoma, and paraneoplastic syndromes: A case report

We report a diagnostically challenging case of a 66-year-old woman with EBV-positive polymorphic B-cell lymphoproliferative disorder (LPD), angioimmunoblastic T-cell lymphoma (AITL), and endometrial adenocarcinoma. Her initial presentation with RS3PE syndrome and a cutaneous eruption mimicking infla...

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Veröffentlicht in:Human Pathology Reports Jg. 41; S. 300791
Hauptverfasser: Fiedler, Jacob, Aiello, D.O. Caterina, Jawaid, Tabinda, Anderson, Carinne, Rudinskaya, Alla, Rella, Vincent, West, Jeffrey, Gupta, Gunjan, Fiedler, Paul
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Elsevier Inc 01.09.2025
Elsevier
Schlagworte:
Angioimmunoblastic T-cell Lymphoma (AITL)
Breast cancer survivor
Cutaneous manifestations
Endometrial adenocarcinoma
Epstein-Barr virus-associated lymphoproliferative disorder (EBV + LPD)
Immunosuppression
Oncologic dermatology
Paraneoplastic syndromes
Pathology
RS3PE syndrome (Remitting Seronegative Symmetrical Synovitis with Pitting Edema)
Vascular Endothelial Growth Factor (VEGF)
LPD
Vascular Endothelial Growth Factor (VEGF)
VEGF
Angioimmunoblastic T-cell Lymphoma (AITL)
Paraneoplastic syndromes
RS3PE
Epstein-Barr virus-associated lymphoproliferative disorder (EBV + LPD)
RS3PE syndrome (Remitting Seronegative Symmetrical Synovitis with Pitting Edema)
Immunosuppression
Breast cancer survivor
EBV
Oncologic dermatology
Endometrial adenocarcinoma
Cutaneous manifestations
Lymphoproliferative disorder
Remitting seronegative symmetrical synovitis with pitting edema
Epstein-Barr virus
Vascular endothelial growth factor
ISSN:2772-736X, 2772-736X
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Zusammenfassung:We report a diagnostically challenging case of a 66-year-old woman with EBV-positive polymorphic B-cell lymphoproliferative disorder (LPD), angioimmunoblastic T-cell lymphoma (AITL), and endometrial adenocarcinoma. Her initial presentation with RS3PE syndrome and a cutaneous eruption mimicking inflammatory breast carcinoma delayed recognition of underlying lymphoid malignancy. Skin biopsy revealed EBV + LPD, and months later she was diagnosed with AITL via lymph node biopsy. All three neoplasms have been linked to elevated vascular endothelial growth factor (VEGF), suggesting a shared pathogenic pathway. This case underscores the importance of considering EBV + LPD as a potential early marker of TFH lymphoma, especially in immunosenescent patients, and raises the possibility of RS3PE as a paraneoplastic harbinger of VEGF-driven disease. Multidisciplinary evaluation was essential to untangle the overlapping clinical and pathological findings.
ISSN:2772-736X
2772-736X
DOI:10.1016/j.hpr.2025.300791