ALK-positive anaplastic large T-cell lymphoma preceded by Epstein-Barr virus infection complicated by development of an aorto-esophageal fistula.

We report an unusual case of aggressive ALK-positive anaplastic large cell lymphoma with widespread mediastinal involvement immediately preceded by an acute Epstein-Barr virus (EBV) infection. Following initiation of chemotherapy and radiological evidence of significant tumor regression, the patient suffered a fatal massive upper gastrointestinal hemorrhage from an aorto-esophageal fistula. The relevant literature relating to EBV in the pathogenesis of ALK-lymphomas and literature relating to aorto-enteric fistula (AEF) in mediastinal lymphoma is reviewed.