OBJECTIVE : To present two cases of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer
of the oral mucosa in association with human immunodeficiency virus infection.
STUDY DESIGN : Two recently diagnosed cases of EBV-positive mucocutaneous ulcer of the
oral mucosa in HIV-positive patients were reviewed with regards to their clinical,
histomorphological and immunophenotypic features.
RESULTS : Both cases presented clinically as well circumscribed ulcers which were
histomorphologically characterized by dense superficial polymorphous inflammatory
infiltrates. The infiltrates comprised cells with a predominant B-cell phenotype which ranged
in size from small to intermediate with occasional large immunoblastic forms. Some of the
larger B-cells had a Reed-Sternberg-like morphology. The B-cells were positive for CD20
and co-expressed CD30 and to a lesser extent CD15. EBER positivity was detected in most
of the B-cells.
CONCLUSION : EBV-positive mucocutaneous ulcer represents an unusual form of
lymphoproliferative disorder associated with immune suppression. It should be distinguished
from other forms of HIV-associated oral ulceration.