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Pathological analysis of skin ulcer shows a perivascular lymphocytic infiltrate and fibrinoid necrosis of small vascular wall(HE 400x) (A). The lymphoma cells are positive for EBER(400x) (B).
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F1
The histopathological examination of a skin biopsy sample from the lesion showed vasculitis, and an in-situ hybridization test was positive for EBV-encoded small RNA (EBER) (Figure 1).
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Echocardiogram (apical four-chamber view) at the onset of pulmonary arterial hypertension at 9 years of age, showing severe tricuspid regurgitation (A) and continuous wave doppler estimation of tricuspid reflux velocity 3.88 m/s, PG = 60 mmHg (B).
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F2
On echocardiography, the estimated systolic pulmonary arterial pressure (PAP; evaluated on the basis of the tricuspid regurgitation velocity), was 60 mmHg, suggestive of PAH (Figure 2).
Enhanced coronary CT examination showing left and right coronary artery aneurysms (A), and three-dimensional CT reconstruction of the aorta showing dilation of the aortic root and the left anterior descending coronary artery (B). CT, computed tomography; LAD, left anterior descending; RCA, right coronary artery.
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F3
The bilateral pulmonary and coronary arteries were also found to be dilated (Figure 3), while the abdominal aortic stem and the distal section of the superior mesenteric artery showed minor dilatation.
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