Senile EBV-associated B-cell lymphoproliferative disorder of prepatellar bursa in an elderly patient with multifocal urate arthropathy.

We report a case of an EBV-associated high grade B-cell lymphoproliferative disorder occurring in the synovial membrane of an elderly patient with gout arthropathy. The EBV-infected B-cells displayed a pattern of viral gene expression (EBNA2+/LMP1+) typically seen during primary EBV-infection and in lymphoproliferations occurring in immunosuppressed individuals. This case conforms to senile EBV-associated lymphoproliferative disorders previously reported only in Japanese patients. We suggest that an impaired EBV-specific T-cell immunity, local or systemic, may play a role in the development of this disorder and that chronic diseases such as gout may be contributing factors.