A Case Of Epstein-Barr Virus-Positive Diffuse Large B-cell Lymphoma Of The Elderly With Immune Thrombocytopenic Purpura As The Initial Presentation And Literature Review

Objective:To investigate the clinical manifestations of Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma of the elderly with immune thrombocytopenic purpura as the initial presentation,and to summarize the To summarize the clinical characteristics of non-Hodgkin's lymphoma the elderly with immune thrombocytopenic purpura as the initial presentation.Methods:A case of Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma of the elderly with immune thrombocytopenic purpura as the initial presentation with clinical characteristics,auxiliary examination,diagnosis and therapeutic effect were retrospectively analyzed,and relevant literatures were reviewed.Results:A 72-year-old man was diagnosed with ITP because of platelet reduction for the first time.The routine ITP treatment was not effective.His platelet count is back to norma after treatment with Eltrombopag.Three months later,he developed superficial lymph node enlargement,nasal congestion and decreased platelets.According to the pathological diagnosis of lymph node biopsies,he was diagnosed with EBV diffused large B-cell lymphoma.After treatment with rituximab chemotherapy regimen(R-VCP),the lymph nodes decreased significantly,nasal congestion improved and platelets recovered.ConclusionElderly male people with immune thrombocytopenic purpura as the initial presentation should be actively excluded from other potential causes,among which non-hodgkin's lymphoma is rare and easily misdiagnosed.It was higher in males than in females.Epstein-Barr Virus-Positive diffuse large B-Cell lymphoma of the elderly with immune thrombocytopenic purpura as the initial presentation is a rare variant of DLBCL.To the best of our knowledge,this is the first report.Moreover,EBV+ diffuse large B cell lymphoma with ITP is more effective in anti-tumor therapy.