Epstein–Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified: A diagnostic challenge

Epstein–Barr virus-positive diffuse large B-cell lymphoma, not otherwise specified (EBV + DLBCL) is a new separate entity included in 2016 WHO classification with dismal prognosis. Hence, awareness is needed for prompt diagnosis and swift treatment. Here, we present a case of a 48-year-old male with multiple cervical lymphadenopathy for 5 months. On examination, the patient had severe pallor and multiple firm to hard nontender cervical lymph nodes. Bone marrow aspiration was a dry tap. Bone marrow biopsy revealed nodular collection of atypical monomorphic lymphoid cells admixed with lymphocytes, eosinophils, and plasma cells in the background. Lymph node biopsy demonstrated total effacement of normal lymph node architecture with atypical lymphoid cells. These cells were positive for CD20, CD30, and CD38, LMP1, myc, IRF4/MUM1, and FOXP1 and were negative for anaplastic lymphoma kinase, CD3, CD10, bcl2, bcl6, and CD15. Diagnosis of EBV-positive DLBCL was rendered.