tetano
Editor, Senior Moderator
Pathol Int
. 2023 Dec 20.
doi: 10.1111/pin.13398. Online ahead of print. The first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma that deteriorated after COVID-19 vaccination
Ziyao Wang[SUP] 1 [/SUP], Reiji Muto[SUP] 1 2 3 [/SUP], Hiroaki Miyoshi[SUP] 2 [/SUP], Mikiko Aoki[SUP] 1 [/SUP], Noriko Uesugi[SUP] 1 [/SUP], Hiroyuki Murayama[SUP] 4 [/SUP], Kosuke Masutani[SUP] 4 [/SUP], Makoto Hamasaki[SUP] 1 [/SUP]
Affiliations
This is the first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma (EBV + MZL) with an other iatrogenic immunodeficiency-associated lymphoproliferative disorders (LPD) (methotrexate [MTX]-associated LPD) that deteriorated after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. This case had a unique immunophenotype. A 71-year-old female patient with rheumatoid arthritis receiving MTX presented with fatigue 1 week after the SARS-CoV-2 vaccination. She was hospitalized due to hepatorenal dysfunction and pancytopenia. Computed tomography revealed systemic lymphadenopathy. Her physical condition deteriorated, and the patient died. The autopsy revealed systemic lymphadenopathy comprising medium-sized atypical lymphocytes and scattered Hodgkin/Reed-Sternberg (H/RS)-like cells. An immunohistochemical examination showed that atypical lymphocytes were positive for CD79a and MUM-1 and some were positive for CD20 and IRTA-1. H/RS-like cells were immunoreactive for CD30 and CD15 and ringed by T cells. Both cell types were positive for EBV-encoded small RNA. The majority of H/RS-like cells were positive for CD20, whereas a small number of CD3-positive cells were admixed. We herein presented the first autopsy case of EBV + MZL that deteriorated after the SARS-CoV-2 vaccination.
Keywords: COVID-19; SARS-CoV-2; autopsy; methotrexate-associated lymphoproliferative disorder; other iatrogenic immunodeficiency-associated lymphoproliferative disorders; vaccination.
. 2023 Dec 20.
doi: 10.1111/pin.13398. Online ahead of print. The first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma that deteriorated after COVID-19 vaccination
Ziyao Wang[SUP] 1 [/SUP], Reiji Muto[SUP] 1 2 3 [/SUP], Hiroaki Miyoshi[SUP] 2 [/SUP], Mikiko Aoki[SUP] 1 [/SUP], Noriko Uesugi[SUP] 1 [/SUP], Hiroyuki Murayama[SUP] 4 [/SUP], Kosuke Masutani[SUP] 4 [/SUP], Makoto Hamasaki[SUP] 1 [/SUP]
Affiliations
- PMID: 38116849
- DOI: 10.1111/pin.13398
This is the first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma (EBV + MZL) with an other iatrogenic immunodeficiency-associated lymphoproliferative disorders (LPD) (methotrexate [MTX]-associated LPD) that deteriorated after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. This case had a unique immunophenotype. A 71-year-old female patient with rheumatoid arthritis receiving MTX presented with fatigue 1 week after the SARS-CoV-2 vaccination. She was hospitalized due to hepatorenal dysfunction and pancytopenia. Computed tomography revealed systemic lymphadenopathy. Her physical condition deteriorated, and the patient died. The autopsy revealed systemic lymphadenopathy comprising medium-sized atypical lymphocytes and scattered Hodgkin/Reed-Sternberg (H/RS)-like cells. An immunohistochemical examination showed that atypical lymphocytes were positive for CD79a and MUM-1 and some were positive for CD20 and IRTA-1. H/RS-like cells were immunoreactive for CD30 and CD15 and ringed by T cells. Both cell types were positive for EBV-encoded small RNA. The majority of H/RS-like cells were positive for CD20, whereas a small number of CD3-positive cells were admixed. We herein presented the first autopsy case of EBV + MZL that deteriorated after the SARS-CoV-2 vaccination.
Keywords: COVID-19; SARS-CoV-2; autopsy; methotrexate-associated lymphoproliferative disorder; other iatrogenic immunodeficiency-associated lymphoproliferative disorders; vaccination.