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06 March 2020 Volume 33 Issue 1

  

Clinical characteristics of an EB virus-positive mucocutaneous ulcer on the tonsil

LI Jingjing, XU Jinkun, LI Li

Journal of Otolaryngology and Ophthalmology of Shandong University. 2020, 33(1):  58-62.  doi:10.6040/j.issn.1673-3770.0.2019.304

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Objective To analyze and evaluate the clinical features, treatment, and prognosis of a patient with an Epstein-Barr virus positive mucocutaneous ulcer(EBV MCU)in order to improve our understanding, and ability to accurately diagnose and treat, this rare and recently described entity. Methods We analyzed clinical data associated with a case of EBV MCU and reviewed the literature that addresses this new disease entity in order to summarize its clinical characteristics, treatment, and prognosis. Results The patient was 91 years old and presented with a two-week history of pharyngalgia. On clinical examination we noted a sharply circumscribed, isolated, and indurated ulcer on the left tonsil. Histologically, the ulcer consisted of a polymorphous infiltrate composed predominantly of small lymphocytes and other inflammatory cells admixed with scattered large atypical cells with large irregular or lobulated nuclei and abundant cytoplasm. The histological findings were positive for CD20, CD30, Pax5, and EBEV. The patient was treated with cephalosporin antibiotics for two weeks, and the ulcer healed completely one month post-onset. Conclusion A EBV MCU in the tonsil showed morphological and imaging characteristics of a malignant tumor, but the disease was self-limited, and generally required only conservation treatment. However, close observation and follow-up are required to monitor the disease progress and potential transformation. Chemoradiotherapy can be administered when necessary.