PMC4898415_01
Clinical course of the case.. Note: After the completion of salvage chemotherapy, a severe lymphopenia lasted >5 months until death.. Abbreviation: B-R, bendamustine and rituximab.
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After completion of the B-R regimen, lymphopenia had continued over 3 months (Figure 1).
Findings of esophagogastroscopy and pathological examination.. Notes: (A) Esophagogastroscopy in normal light observation revealed polynesic white protrusions with shallow ulcers in the mid-esophagus. (B) Shallow ulcers were more apparent by narrow band imaging. (C) Several squamous cells, presenting intranuclear inclusion bodies of Cowdry's type A. Magnification: x100. Inset shows textbook example of Cowdry's type A (green arrowheads). Magnification: x200. (D) These cells with intranuclear inclusion bodies could be positively stained by anti-herpes simplex virus antibody. Magnification: x100.
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Esophagogastroscopy revealed polynesic white protrusions with shallow ulcers in the mid-esophagus (Figure 2A and B). These lesions were diagnosed as HE because several squamous cells had intranuclear inclusion bodies of Cowdry's Type A (Figure 2C), and these cells were positively stained by anti-herpes simplex virus antibody (Figure 2D).