EBV-positive mucocutaneous ulcer of the oral cavity associated with HIV/AIDS.

OBJECTIVE To present 2 cases of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer of the oral mucosa in association with human immunodeficiency virus infection. STUDY DESIGN Two recently diagnosed cases of EBV-positive mucocutaneous ulcer of the oral mucosa in patients with human immunodeficiency virus (HIV) were reviewed with regard to their clinical, histomorphologic, and immunophenotypic features. RESULTS Both cases presented clinically as well-circumscribed ulcers that were histomorphologically characterized by dense superficial polymorphous inflammatory infiltrates. The infiltrates comprised cells with a predominant B-cell phenotype that ranged in size from small to intermediate with occasional large immunoblastic forms. Some of the larger B cells had a Reed-Sternberg-like morphology. The B cells were positive for CD20 and coexpressed CD30 and to a lesser extent CD15. Epstein-Barr virus-encoded small RNA (EBER) positivity was detected in most of the B cells. CONCLUSIONS EBV-positive mucocutaneous ulcer represents an unusual form of lymphoproliferative disorder associated with immune suppression. It should be distinguished from other forms of HIV-associated oral ulceration.