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EBV+ Diffuse Large B-cell Lymphoma (DLBCL), NOS - Clinical Features: It is a disease of the elderly (peak incidence in 8th decade) with a slight male predilection. The patients have no underlying immunodeficiencies or prior lymphoma diagnosis; however, the age-related decline in immune functions and diminished resistance to viral infections appears to play a role in its pathogenesis. It usually involves extranodal sites such as skin, lung, tonsils, and gastrointestinal tract (as shown in this case with colon involvement). Nodal sites may or may not be affected. In the elderly patients, it is an aggressive lymphoma with a median survival of 2-3 years.

A second smaller peak is seen in younger patients (<45-50 years; median age 23 years) who almost always have nodal disease (90% of cases) and a much better prognosis than elderly patients.

Image courtesy of: Genevieve Crane, MD, PhD.

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