悪性リンパ腫と鑑別を要したEBウイルス感染症の2例

Two cases of difficult discrimination between acute or chronic infection associated with Epstein-Barr virus and malignant lymphoma

Ⅰ．はじめに

　Epstein Barr（EB）ウイルス感染症の急性期は，細胞の異型性が強く，病理組織学的に悪性リンパ腫との鑑別診断が困難な場合があるとされている^1）。特にEBウイルス感染の病巣になりやすい扁桃病変の鑑別診断には慎重を要する。われわれは他院の生検にて悪性リンパ腫と診断され，当院の臨床経過や検査により伝染性単核球症と診断した症例と，臨床経過から悪性リンパ腫を強く疑ったが病理組織診断にてEBウイルスの関与する炎症と診断した症例を経験したで，若干の文献的考察を加えて報告する。

　The author encountered the following two patients. One was diagnosed previously of malignant lymphoma based on histopathological examinations. However, from his clinical course, this diagnosis was changed to infectious mononucleosis. The other patient was strongly suggestive of having malignant lymphoma from the clinical course. But later diagnosis of inflammation due to EB virus was made. For differential diagnosis of malignant lymphoma and acute inflammatory diseases, it is important to reach a comprehensive diagnosis, including the observation of clinical courses, instead of relying on pathological observations.