Spontaneous Remission of Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma of the Elderly

Abstract

A 94-year-old female patient presented with anorexia and left axillar lymphadenopathy on admission. Her past history was angina pectoris at 83 years of age and total gastrectomy due to gastric cancer at 87 years. The family history revealed that her son had had a malignant lymphoma, the histopathological diagnosis of which was diffuse large B-cell lymphoma. A physical examination showed both cervical, axillar, and inguinal lymphadenopathy without tenderness. She had elevated lactate dehydrogenase, ferritin, and soluble interleukin-2 receptor (sIL-2R). Whole-body computed tomography confirmed the cervical, axillary, and inguinal lymphadenopathy. Gallium-68 imaging revealed positive accumulation in these superficial lymph nodes. A right inguinal lymph node biopsy showed features of Epstein-Barr virus-associated lymphoproliferative disorder. Immunohistological studies on this lymph node biopsy showed CD20-positive large cells, CD3-positive small cells, and CD30-partly-positive large cells. In situ hybridization showed Epstein-Barr virus-positive, LMP-partly-positive, and EBNA2-negative cells. She refused chemotherapy as her son had died from hematemesis during chemotherapy. She received intravenous hyperalimentation for 1 month after admission. No palpable lymph nodes were identified by physical examination or computed tomography 3 months after admission, and regression of lactate dehydrogenase, ferritin, and sIL-2R was observed. She recovered from anorexia and was discharged. She died from pneumonia 10 months later after initial symptoms of anorexia. The autopsy showed no superficial lymphadenopathy.

Spontaneous Regression of Epstein‐Barr Virus‐negative Diffuse Large B‐cell Lymphoma that Presented with Multiple Pulmonary Nodules

“…Importantly, EBV infection is a well-known cause of post-transplant lymphoproliferative disorders, 9,10 drug-induced hypersensitivity syndrome, 11 and pyothorax-associated lymphoma, 12 but it is rarely reported as a cause of spontaneous regression or remission of DLBCL. 13 Furthermore, the present case had no definite evidence of EBV infection, both in the resected inguinal lymph nodes and the specimens obtained from TBLB or EBUS-TBNA. Thus, the present case showed an extremely rare phenomenon, in that 1) spontaneous regression of lung involvement occurred in a patient with DLBCL, and 2) there was no definite evidence of EBV infection in the lung.…”

Long-term spontaneous regression of Stage IV diffuse large B-cell lymphoma

“…Information on the few cases of progressive DLBCL with SR (n=3) is presented in Table 1 . 5 , 18 , 19 In 2 patients EB virus was positive, 5 , 18 and in the third, no information on this point was published. The 2 cases of DLBCL associated with EB virus infection were ABC-type DLBCL, as were most other DLBCL that achieved SR in other reviews.…”

Spontaneous Regression of a Carcinoid Tumor following Pregnancy

“…Spontaneous regression of malignant tumours (referred to as spontaneous regression of cancer, SRC) refers to partial or complete disappearance of cancer without medical intervention. It is a very rare phenomenon but has been reported in a variety of cancers, including malignant lymphoma [ 12 , 13 ], renal cell carcinoma [ 14 , 15 ], hepatocellular carcinoma [ 16 ], and neuroblastoma [ 17 ]. Although SRC has often been questioned, the literature describes a number of cases demonstrating this phenomenon.…”