Abstract
Two siblings with Epstein-Barr virus (EBV), heterophil negative lympho-proliferative disease are described. The sister presented first with heterophil negative infectious mononucleosis which was virologically confirmed EBV and which progressed to a fatal outcome. Cervical node biopsy revealed lymphocytes containing both EBV nuclear antigen (EBV-EBNA) and EBV early antigen (EBV-EA). At autopsy, there was widespread infiltration of spleen, lymph nodes, lungs and heart with lymphocytes demonstrating both of these EBV-coded antigens. Subsequently, her brother presented with a picture of disseminated lympho-proliferative disease which was serologically and virologically confirmed as due to EBV. T&A and cervical node biopsy were shown to harbor numerous EBV-EBNA and EBV-EA lymphocytes. A short period of improvement occurred to be followed by recurrence leading ultimately to re-evaluation. Cervical node biopsy followed by staging laparotomy demonstrated Stage III-B mixed cellular Hodgkin's Disease. In these speciments, there was again confirmation of the presence of EBV. X-ray therapy and multiple agent chemotherapy has been followed by remission of the Hodgkin's Disease. Concurrent studies of EBV serology reflects this fact also. Details of the pathologic studies and EBV virus studies will be presented. It is postulated that in this child EBV virus can be implicated etiologically in his Hodgkin's Disease in a prospective study.
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