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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Vydáno v:	Human Pathology Reports Ročník 41; s. 300791
Hlavní autoři:	Fiedler, Jacob, Aiello, D.O. Caterina, Jawaid, Tabinda, Anderson, Carinne, Rudinskaya, Alla, Rella, Vincent, West, Jeffrey, Gupta, Gunjan, Fiedler, Paul
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Elsevier Inc 01.09.2025 Elsevier
Témata:	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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Shrnutí:	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