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A-39-Year-Old-Woman-With-Synchronous-Endobronchial
A-39-Year-Old-Woman-With-Synchronous-Endobronchial
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The document discusses a case of a 39-year-old woman diagnosed with Epstein-Barr Virus-associated smooth muscle tumors (EBV-SMTs) involving the bronchial and adrenal regions. The patient, who had a history of systemic lupus erythematosus and a subsequent renal transplant, presented with a chronic nonproductive cough and occasional wheezing. Physical examination revealed mild inspiratory wheezing on the left side of the lung. Diagnostic imaging identified a 7-mm endobronchial lesion and a 3-cm adrenal nodule. Both lesions were found to be neoplastic spindle cell tumors, confirmed to be EBV-associated smooth muscle tumors via histology and in situ hybridization.<br /><br />EBV-SMTs are rare and typically occur in immunocompromised individuals, such as those who have undergone transplantation. They can appear anywhere in the body but have a propensity for sites with little smooth muscle and may present at multiple sites simultaneously. In this case, both the endobronchial and adrenal tumors were successfully resected, leading to the resolution of the patient's cough. Importantly, the EBV-SMTs are characterized by a lack of histologic atypia and necrosis, and their behavior is more dependent on the patient's immune status than the tumor's histology.<br /><br />The prognosis for patients with EBV-PTSMT is generally favorable with surgical intervention, although high-risk cases, particularly those with intracranial manifestations, may have a poorer outcome. Treatment revolves around reducing immunosuppression to enhance immune function, without jeopardizing transplant viability. Conventional treatments like chemotherapy and radiotherapy may also aid in managing these tumors. The document underscores the necessity of considering EBV-SMT in the differential diagnosis for immunocompromised patients with endobronchial masses.
Keywords
Epstein-Barr Virus
smooth muscle tumors
EBV-SMT
immunocompromised
renal transplant
endobronchial lesion
adrenal nodule
systemic lupus erythematosus
neoplastic spindle cell
surgical intervention
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