Epstein-Barr Virus Positive Diffuse Large B Cell Lymphoma Of The Elderly Arising In Nasal Cavities And Sinuses: A Case Report

Epstein-Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) of the elderly, characterized by a suboptimal response to therapy and poor survival rate, is a highly aggressive B-cell lymphoma without any known underlying immunosuppression or prior lymphoma. Unlike NK/T cell lymphoma, it rarely occurs in the nasal cavity. Here we report a case of EBV+DLBCL of the elderly primarily arising in the nasal cavities and sinuses in a 62-year-old female who presented with nasal congestion and left eye blindness. CT scan showed that the neoplasm invaded bilateral nasal cavities and adjacent sinuses, and bilateral eye sockets. Microscopically it showed diffuse infiltration of medium to large lymphocytes with extensive necrosis. The atypical cells were positive for CD20, MUM1, and CD30, negative for CD10, CD15, CD2, CD3, TIA1, CD21, and CD56. In situ hybridization for Epstein-Barr virus-encoded ribonucleic acid was positive. The patient underwent 5 cycles of CHOP regimens, and partial remission was achieved, but the patient died from infection and multiple organ failures. It was only 5 months from the time of diagnosis to the patient demise.