Q. A55 years old recent immigrant from twain presents to the clinic with a 3 months of worsening nasal congestion, epistaxis and recurrent ear infections. Physical examination reveals painless firm lymph node enlargement in the neck. CT of the head reveals a large mass satiated in the upper nasopharynx. Biopsy shows large epithelioid cells intermixed with numerous infiltrating lymphocytes. The infectious agent directly associated with the patient pathology best described by witch category? A.DNA virus B.Eubacterium C.Fungus D.mycobacterium E.RNA virus
The correct answer is A. This patient has developed nasopharyngeal carcinoma, a condition common in certain parts of the world, including Asia and Africa. Development of this tumor is always associated with infection by Epstein-Barr virus (EBV), a DNA virus in the herpesvirus family. Development of this tumor is believed to be related to a synergistic interaction between EBV and a diet high in carcinogenic nitrosamines (common in foods that has been smoked or preserved). Common symptoms include nasal congestion, epistaxis, ear infections (due to tumor-induced blockage of the Eustachian tubes), and headache.
