Skip to main content

Advertisement

Log in

Laryngeal Epstein–Barr Virus-Associated Smooth Muscle Tumor in an Undernourished Child

  • Case Report
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Smooth muscle tumors associated with Epstein–Barr virus infections (EBV–SMT) of laryngeal origin are exceedingly rare and have been reported in few adult patients, but not in children. This reported case describes a lesion found in the larynx of an 8-year-old Guatemalan undernourished girl. Microscopically, the lesion showed a highly cellular mesenchymal spindle cell tumor, containing frequent lymphocytes. The immunohistochemical analysis revealed positivity for α-smooth muscle actin and h-caldesmon. In addition, most of the tumor cells were positive for EBV by in situ hybridization. To the best of the author’s knowledge, this is the first literature-reported case of laryngeal EBV–SMT occurring in an undernourished child.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Grywalska E, Rolinski J. Epstein–Barr virus-associated lymphomas. Semin Oncol. 2015;42(2):291–303. https://doi.org/10.1053/j.seminoncol.2014.12.030.

    Article  PubMed  Google Scholar 

  2. Jha HC, Pei Y, Robertson ES. Epstein–Barr virus: diseases linked to infection and transformation. Front Microbiol. 2016;7(OCT):1602. https://doi.org/10.3389/fmicb.2016.01602.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Rumayor Piña A, dos Santos HT, Carlos R, Altemani A, de Almeida OP. Epstein–Barr virus in nasopharyngeal carcinoma of Guatemalan and Brazilian patients. Int J Surg Pathol. 2017;25(4):304–9. https://doi.org/10.1177/1066896916679518.

    Article  PubMed  Google Scholar 

  4. Kazmi SAJ, Aizenberg MR, Harper JL, McComb RD. Multifocal histologically malignant Epstein–Barr virus-associated smooth muscle tumor in a pediatric transplant patient with an indolent course. Int J Surg Pathol. 2014;22(2):186–9. https://doi.org/10.1177/1066896913494793.

    Article  PubMed  Google Scholar 

  5. Jossen J, Chu J, Hotchkiss H, et al. Epstein–Barr virus-associated smooth muscle tumors in children following solid organ transplantation: a review. Pediatr Transpl. 2015;19(2):235–43. https://doi.org/10.1111/petr.12426.

    Article  Google Scholar 

  6. Deyrup AT, Lee VK, Hill CE, et al. Epstein–Barr virus-associated smooth muscle tumors are distinctive mesenchymal tumors reflecting multiple infection events: a clinicopathologic and molecular analysis of 29 tumors from 19 patients. Am J Surg Pathol. 2006;30(1):75–82. https://doi.org/10.1097/01.pas.0000178088.69394.7b.

    Article  PubMed  Google Scholar 

  7. Gan EC, Lau DPC, Chuah KL. Epstein–Barr virus-associated smooth muscle tumour mimicking bilateral vocal process granuloma. J Laryngol Otol. 2008;122(1):100–4. https://doi.org/10.1017/S0022215107007682.

    Article  CAS  PubMed  Google Scholar 

  8. Huang J, Loh KS, Petersson F. Epstein–Barr virus-associated smooth muscle tumor of the larynx: report of a rare case mimicking leiomyosarcoma. Head Neck Pathol. 2010;4(4):300–4. https://doi.org/10.1007/s12105-010-0201-7.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hatton OL, Harris-Arnold A, Schaffert S, Krams SM, Martinez OM. The interplay between Epstein–Barr virus and B lymphocytes: implications for infection, immunity, and disease. Immunol Res. 2014;58(0):268–76. https://doi.org/10.1007/s12026-014-8496-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hutt-Fletcher LM. Epstein–Barr virus replicating in epithelial cells. Proc Natl Acad Sci USA. 2014;111(46):16242–3. https://doi.org/10.1073/pnas.1418974111.

    Article  CAS  PubMed  Google Scholar 

  11. Ha C, Haller JO, Rollins NK. Smooth muscle tumors in immunocompromised (HIV negative) children. Pediatr Radiol. 1993;23(5):413–4. https://doi.org/10.1007/BF02011979.

    Article  CAS  PubMed  Google Scholar 

  12. Hussein K, Rath B, Ludewig B, Kreipe H, Jonigk D. Clinico-pathological characteristics of different types of immunodeficiency-associated smooth muscle tumours. Eur J Cancer. 2014;50(14):2417–24. https://doi.org/10.1016/j.ejca.2014.06.006.

    Article  PubMed  Google Scholar 

  13. Dekate J, Chetty R. Epstein–Barr virus-associated smooth muscle tumor. Arch Pathol Lab Med. 2016;140(7):718–22. https://doi.org/10.5858/arpa.2015-0120-RS.

    Article  PubMed  Google Scholar 

  14. Arva NC, Schafernak KT. Rare presentations of Epstein–Barr Virus-associated smooth muscle tumor in children. Pediatr Dev Pathol. 2016;19(2):132–8. https://doi.org/10.2350/15-05-1627-CR.1.

    Article  PubMed  Google Scholar 

  15. Garg I, Baladron Zanetti MJ, Yasir S, Goenka AH, Kendi AT. PET/CT in an 8-year-old girl with Epstein–Barr virus-associated smooth muscle tumor. Clin Nucl Med. 2017;42(10):770–2. https://doi.org/10.1097/RLU.0000000000001794.

    Article  PubMed  Google Scholar 

  16. Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147–52. https://doi.org/10.1016/S0140-6736(05)71877-8.

    Article  PubMed  Google Scholar 

  17. Rytter MJH, Kolte L, Briend A, Friis H, Christensen VB. The immune system in children with malnutrition—a systematic review. PLoS ONE. 2014;9(8):e105017. https://doi.org/10.1371/journal.pone.0105017.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Bourke CD, Berkley JA, Prendergast AJ. Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol. 2016;37(6):386–98. https://doi.org/10.1016/j.it.2016.04.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Völker H-U, Scheich M, Zettl A, Hagen R, Müller-Hermelink HK, Gattenlöhner S. Laryngeal inflammatory myofibroblastic tumors: different clinical appearance and histomorphologic presentation of one entity. Head Neck. 2010;32(11):1573–1578. https://doi.org/10.1002/hed.21232.

    Article  PubMed  Google Scholar 

  20. Oliva E, Young RH, Amin MB, Clement PB. An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am J Surg Pathol. 2002;26(4):403–412.

    Article  Google Scholar 

  21. Rogatsch H, Bonatti H, Menet A, Larcher C, Feichtinger H, Dirnhofer S. Epstein–Barr virus-associated multicentric leiomyosarcoma in an adult patient after heart transplantation: case report and review of the literature. Am J Surg Pathol. 2000;24(4):614–621.

    Article  CAS  Google Scholar 

  22. Suwansirikul S, Sukpan K, Sittitrai P, Suwiwat S, Khunamornpong S. Epstein–Barr virus-associated smooth muscle tumor of the tonsil. Auris Nasus Larynx. 2012;39(3):329–32. https://doi.org/10.1016/j.anl.2011.07.013.

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by São Paulo Research Foundation (FAPESP), Grant Number #2015/25905-1.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ciro Dantas Soares.

Ethics declarations

Conflict of interest

The authors declare no potential conflicts of interest related to this case report, to this study’s authorship, and/or to its publication.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Soares, C.D., Carlos, R., Molina, J.P.D. et al. Laryngeal Epstein–Barr Virus-Associated Smooth Muscle Tumor in an Undernourished Child. Head and Neck Pathol 13, 722–726 (2019). https://doi.org/10.1007/s12105-018-0960-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-018-0960-0

Keywords

Navigation