Multifocal osteochondromatous proliferation and paraneoplastic hematologic dyscrasia in the context of latent Epstein-Barr virus reactivation: a case of oncologic and infectious pathophysiology

TL;DR

A 15-year-old boy showed bone growths and blood issues linked to a reactivated Epstein-Barr virus, suggesting a new connection between the virus and these conditions.

Contribution

This is the first reported case linking Epstein-Barr virus reactivation to both osteochondromatous proliferation and paraneoplastic hematologic dyscrasia.

Findings

Radiographic imaging showed widespread skeletal lesions consistent with osteochondromatosis.

Hematologic evaluation revealed pancytopenia and dysplastic megakaryocytes with marrow infiltration.

Immunohistochemistry confirmed latent Epstein-Barr virus infection, implicating it in the observed pathologies.

Abstract

This case report describes a 15-year-old male with multifocal osteochondromatous proliferation and paraneoplastic hematologic dyscrasia, linked to latent Epstein-Barr virus reactivation. Radiographic and advanced imaging revealed widespread skeletal lesions consistent with osteochondromatosis. Hematologic evaluation indicated pancytopenia with dysplastic megakaryocytes and marrow infiltration. Immunohistochemical staining confirmed latent Epstein-Barr virus infection, suggesting its role in the pathogenesis of both the osteochondromatous and hematologic abnormalities. This case highlights the correlation between Epstein-Barr virus reactivation, bone proliferation, and paraneoplastic hematologic processes, which we believe has not yet been reported in the literature, emphasizing the need for a comprehensive diagnostic approach.

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