PMC5917941_01
Necrotic ulcerations expanding across the hard and soft palate.
CG-CGCR180020F001.jpg
PMC5917941_01_CG-CGCR180020F001.jpg
F1
Two months prior to presentation, she was seen by a maxillofacial surgeon for weight loss and a painful expanding sore on her hard palate (Figure 1).
(A) Ulceration with underlying infiltrate of atypical small- to large-sized lymphoid cells (hematoxylin eosin, x100). (B) Numerous EBV positive cells shown on in situ hybridization for EBV-encoded RNA, x400.
CG-CGCR180020F002.jpg
PMC5917941_01_CG-CGCR180020F002.jpg
F2
A tissue biopsy was consistent with EBVMCU, and she was prescribed topical triamcinolone (Figure 2).
Resolution of the ulcerations 12 weeks after stopping azathioprine therapy.
CG-CGCR180020F003.jpg
PMC5917941_01_CG-CGCR180020F003.jpg
F3
She was seen 12 weeks after discontinuation of azathioprine, and although she remained anemic, her ulcers had completely resolved and she had no symptoms suggesting active Crohn's disease (Figure 3).