# 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.

## Key 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.