Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T04:31:43.326Z Has data issue: false hasContentIssue false
  • English
  • Français

Epstein–Barr virus-associated smooth muscle tumour mimicking bilateral vocal process granuloma

Published online by Cambridge University Press:  20 April 2007

E C Gan ,
D P C Lau  and
K L Chuah
E C Gan*
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
D P C Lau
Affiliation:
Department of Otolaryngology, Singapore General Hospital, Singapore
K L Chuah
Affiliation:
Visiting Consultant, Department of Pathology, Singapore General Hospital, Singapore
*
Address for correspondence: Dr Eng Cern Gan, Department of Otolaryngology, Singapore General Hospital, Outram Road, Singapore169608. Fax: 6226 2079 E-mail: ecgan@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

A case is presented of a 36-year-old Chinese woman with a renal transplant for end-stage renal failure due to Goodpasture's syndrome. She presented with a year's history of throat discomfort and acid regurgitation into her throat. Videolaryngoscopy revealed bilateral vocal process granuloma, presumed to be due to gastroesophageal reflux. A four-week course of high dose omeprazole was prescribed. On follow up a month later, the granulomas had enlarged, and laser excision was undertaken. Histological and immunohistochemical staining was consistent with Epstein–Barr virus-associated smooth muscle tumour. This is believed to be the first reported case in the English literature of such a tumour affecting the vocal process. The aim of this paper is to present the pathogenesis, clinical behaviour and treatment of Epstein–Barr virus-associated smooth muscle tumour, and to review the literature concerning the differential diagnosis of polypoid vocal process lesions.

Keywords

Epstein Barr virussmooth muscle tumourlarynx immunocompromisedgranulomasvocal process
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 1 , January 2008 , pp. 100 - 104
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Debriec-Rychter, M, Croes, R, De Vos, R, Marynen, P, Roskams, T, Hagemeijer, A et al. Complex genomic rearrangement of ALK loci associated with integrated human Epstein-Barr virus in a post-transplant myogenic liver tumor. Am J Pathol 2003;163:913–22CrossRefGoogle Scholar
2Deyrup, AT, Lee, VK, Hill, CE, Cheuk, W, Toh, HC, Kesavan, S et al. Epstein-Barr virus-associated smooth muscle tumors are distinctive mesenchymal tumors reflecting multiple events: a clinicopathologic and molecular analysis of 29 tumors from 19 patients. Am J Surg Pathol 2006;30:75–82CrossRefGoogle Scholar
3Cheuk, W, Li, PC, Chan, JK. Epstein-Barr virus associated smooth muscle tumour: a distinctive mesenchymal tumour of immunocompromised individuals. Pathology 2002;34:245–9CrossRefGoogle ScholarPubMed
4Lee, E, Dickman, P, Jaffe, R, Alashari, M, Tzakis, A, Reyes, J. Post-transplant spindle cell tumor (PTST): an entity associated with Epstein Barr virus. Mod Pathol 1993;6:127AGoogle Scholar
5Liebowitz, D. Epstein-Barr virus – an old dog with new tricks. N Engl J Med 1995;332:55–7CrossRefGoogle ScholarPubMed
6Lee, ES, Locker, J, Nalesnik, M, Reyes, J, Jaffe, R, Alashari, M et al. The association of Epstein-Barr virus with smooth-muscle tumors occurring after organ transplantation. New Engl J Med 1995;332:19–25CrossRefGoogle ScholarPubMed
7Wang, F, Gregory, C, Sample, C, Rowe, M, Liebowitz, D, Murray, R et al. Epstein-Barr virus latent membrane protein (LMP1) and nuclear proteins 2 and 3c are effectors in phenotypic changes in B lymphomas: EBNA-2 and LMP1 cooperatively induce CD23. J Virol 1990;64:2309–18CrossRefGoogle Scholar
8Morgello, S, Kotsianti, A, Gumprecht, JP, Moore, F. Epstein-Barr virus-associated dural leiomyosarcoma in a man infected with human immunodeficiency virus. J Neurosurg 1997;86:883–7CrossRefGoogle Scholar
9McClain, KL, Leach, CT, Jenson, HB, Joshi, VV, Pollock, BH, Parmley, RT et al. Association of Epstein-Barr virus with leiomyosarcomas in young people with AIDS. N Engl J Med 1995;332:12–18CrossRefGoogle ScholarPubMed
10Boman, F, Gultekin, H, Dickman, PS. Latent Epstein-Barr virus infection demonstrated in low grade leiomyosarcomas of adults with acquired immunodeficiency syndrome, but not in adjacent Kaposi's lesion or smooth muscle tumors in immunocompetent patients. Arch Pathol Lab Med 1997;121:834–8Google ScholarPubMed
11Creager, AJ, Maia, DM, Funkhouser, WK. Epstein-Barr virus-associated renal smooth muscle neoplasm: report of a case with review of the literature. Arch Pathol Lab Med 1998;122:277–81Google ScholarPubMed
12Benjamin, B, Croxson, G. Vocal cord granulomas. Ann Otol Rhinol Laryngol 1985;94:538–41CrossRefGoogle ScholarPubMed
13Holinger, PH, Johnston, KC. Contact ulcers of the larynx. JAMA 1960;172:511–15CrossRefGoogle Scholar
14Hoffmann, HT, Overholt, E, Karnell, M, McCulloch, TM. Vocal process granuloma. Head Neck 2001;23:1061–74CrossRefGoogle Scholar
15Havas, TE, Priestley, J, Lowinger, DS. A management strategy for vocal process granulomas. Laryngoscope 1999;109:301–6CrossRefGoogle ScholarPubMed
16Ylitalo, R, Lindestad, PA. A retrospective study of contact granuloma. Laryngoscope 1999;109:433–6CrossRefGoogle ScholarPubMed
17New, GB, Devine, KD. Contact ulcer granuloma. Ann Otol Rhinol Laryngol 1949;58:548–58CrossRefGoogle ScholarPubMed
18Wenig, BM, Heffner, DK. Contact ulcers of the larynx: a reacquaintance with the pathology of an often under-diagnosed entity. Arch Pathol Lab Med 1990;114:825–8Google Scholar
19Jaroma, M, Pakarinen, L, Nuutinen, J. Treatment of vocal cord granuloma. Acta Otolaryngol (Stockh) 1989;107:296–9CrossRefGoogle ScholarPubMed
20Sidle, DM, Haines, GK 3rd, Altman, KW. Bilateral vocal process papillomas: report of a case. Ear Nose Throat J 2002;81:790–1CrossRefGoogle ScholarPubMed