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EBV-associated gastritis
Tuesday 25 September 2007
Gastrointestinal symptoms of EBV infection are nonspecific and occur rarely. EBV inducing acute gastrointestinal pathology is poorly recognized without suspicion.
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EBV-related gastritis
Synopsis
severe gastritis associated with primary Epstein-Barr virus (EBV) infection in immunocompetent
intermittent fever of unknown origin
epigastric pain
diffuse thickening of the gastric wall
numerous ulcers in the stomach
dense and diffuse atypical lymphoid infiltrate in the lamina propria
erosions
focal lymphoepithelial lesions
no lymphoid follicles
no Helicobacter pylori
Immunohistochemical studies
lymphoid infiltrate to consist of mixed T and B cells.
Immunoglobulin heavy chain gene arrangement analysis
polyclonal pattern.
NP The plasma cells present no light chain restriction by in situ hybridization.
Lab
peripheral lymphocytosis
atypical lymphocytes
positive serum IgM antibody to EBV capsid antigen in the absence of IgG antibody.
In situ hybridization by Eber probe
numerous EBV-positive lymphocytes in the gastric mucosa.
Differential diagnosis
gastric lymphomas
References
Chen ZM, Shah R, Zuckerman GR, Wang HL. Epstein-Barr virus gastritis: an underrecognized form of severe gastritis simulating gastric lymphoma. Am J Surg Pathol. 2007 Sep;31(9):1446-51. PMID: 17721202
