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. 2014 Aug 27;8:288. doi: 10.1186/1752-1947-8-288

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Copyright © 2014 Ameli et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Systemic Epstein-Barr virus-positive T-cell lymphoproliferative childhood disease: bone marrow biopsy. A: Hematoxylin and eosin (H&E) sections illustrate the medium-sized lymphoid cells replacing the normal hematopoietic elements and exhibiting moderate atypia with irregular kidney-shaped nuclei, dispersed chromatin and distinct nucleoli (100x, 400x and 600x respectively left to right). Hemophagocytosis is also easily seen (inset). B: An immunohistochemical study shows that the majority of infiltrated atypical lymphocytes expressed CD2+ and CD4+ with scattered positivity to CD8. C. The atypical lymphoid cells are not immunoreactive to CD20 and there is a paucity of B cells in the bone marrow. Ki-67 immunostaining shows a high proliferative index and EBV-encoded RNA (EBER) by in situ hybridization demonstrates a strong reactivity of atypical lymphoid cells.