Inflammatory pseudotumor of the spleen associated with a clonal Epstein-Barr virus genome: Case report and review of the literature

Jason T. Lewis, Robyn L. Gaffney, Mary B. Casey, Michael A. Farrell, William G. Morice, William R. Macon

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

We report a case of an inflammatory pseudotumor (IPT) of the spleen occurring in an 81-year-old woman with a history of a monoclonal gammopathy of undetermined significance. Eighteen-month follow-up after splenectomy demonstrated no tumor recurrence or progression of underlying plasma cell disease. Histologic examination of the tumor demonstrated a polymorphic population of inflammatory and epithelioid and spindle cells. Immunophenotyping showed large numbers of T cells, B cells, and polyclonal plasma cells. The epithelioid and spindle cells were positive for vimentin and CD68 but lacked expression of follicular dendritic cell markers and actin. Epstein-Barr virus (EBV) genome was identified in the epithelioid and spindle cell population by in situ hybridization using probes specific for EBV-encoded RNAs (EBER1 and EBER2). Southern blot analysis of digested DNA extracted from the tumor using an EBV-specific probe (XhoI) demonstrated the presence of a single high-intensity band, indicative of EBV monoclonality. While there have been 2 previous reports of hepatic IPTs containing a monoclonal population of EBV-infected tumor cells, this is the first report of such an association occurring in the spleen. The presence of clonal EBV DNA suggests some splenic IPTs may be true neoplasms.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
JournalAmerican Journal of Clinical Pathology
Volume120
Issue number1
DOIs
StatePublished - Jul 1 2003

Keywords

  • Clonal Epstein-Barr virus
  • Inflammatory pseudotumor
  • Spleen

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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