EBV-positive mucucutaneous ulcer

Question 1

What is the definition of

EBV positive Mucocutanous ulcer (EBVMCU) ?

Answer 1

• often occurs in the elderly (age-related) or in people with iatrogenic immunosuppression
• morphologically there are Hodgkin-like features
• typically has an indolent course, some show spontaneous regression
• most common site of involvement
  
  • oral cavity
  • note: outgrowth of EBV positive cells can be due to related local trauma or inflammation

Question 2

What is the epidemiology of EBVMCU ?

Answer 2

• incidence has not been well established
• usually occurs in the setting of decreased surveillance for EBV
  
  • age related
  • iatrogenic immunosuppression
    
    • methotrexate
    • azathiprine
    • cyclosporine
    • tumor necrosis factor inhibitors
    • solid organ transplants

Question 3

What is the etiology of EBVMCU ?

Answer 3

• Disease is EBV related
• in the Elderly
  
  • alterations of the T cell response
    
    • accumulation of clonal or oligoclonal restricted CD8+ T cells with diminished functionality
• lesions usually occur in areas of tissue damage
  
  • IBD patients they occur in the intestines

Question 4

What is the localization of EBVMCU ?

Answer 4

• ulcerated lesions usually occur in the oral mucosa, skin, and GI tract
• can have regional, localized lymphadenopathy
  
  • may show reactive hyperplasia
• Note:
  
  • systemic lymphadenopathy, splenomegaly or bone marrow involvement should not be seen