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August 13, 1997

Epstein-Barr Virus and the Immune SystemHide and Seek

Author Affiliations

From the Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.

JAMA. 1997;278(6):510-513. doi:10.1001/jama.1997.03550060086041

CASE PRESENTATION  A 35-YEAR-OLD an was admitted to the Warren Grant Magnuson Clinical Center at the National Institutes of Health, Bethesda, MD, with Burkittlymphoma. The patient had been in good health until 2 months before admission, when he developed back pain. One month before admission, he noted left supraclavicular adenopathy followed by numbness in the left flank, clonus of the left leg, and a rapidly increasing mass in the left paraspinal area. He was admitted to a local hospital, where a biopsy specimen of the supraclavicular node showed lymphoma. A computed tomographic scan showed periaortic and retroperitoneal lymphadenopathy, and a magnetic resonance image showed extradural compression of the spinal cord. The patient received oral dexamethasone and radiotherapy to the area of cord compression; the back pain resolved and the paraspinal mass diminished in size.On examination at the Clinical Center, there was no apparent lymphadenopathy or hepatosplenomegaly, and