Epstein-Barr virus-associated lymphoproliferative disorder mimicking Hodgkin’s lymphoma in immunocompetent patients: A case report and literature review

Epstein-Barr virus (EBV) is the most common infectious agent associated with hemophagocytic lymphohistiocytosis (HLH). This case report discusses a 24-year-old immunocompetent African male presenting with a five-month history of persistent high-grade fever, pancytopenia, and splenomegaly. Initial diagnostic evaluations, including bone marrow biopsy, suggested Hodgkin lymphoma; however, further lymph node biopsy, repeated bone marrow biopsy and comprehensive clinical assessment confirmed EBV-associated lymphoproliferative disorder with HLH. This case underscores the importance of thorough diagnostic approaches, incorporating multiple biopsy sites and advanced imaging, to differentiate between EBV-associated HLH and hematological malignancies such as lymphomas. Enhanced clinical awareness and understanding of HLH's diverse presentations are essential for timely diagnosis and effective management.