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A 52-Year-Old Man Comes to the Office Due to a Progressively

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A 52-year-old man comes to the office due to a progressively enlarging neck mass, fatigue, and weight loss over the past 2 months.  Physical examination shows enlarged, firm, and nontender cervical lymph nodes.  The patient also has enlarged tonsils, bilateral axillary lymphadenopathy, and splenomegaly.  Excisional lymph node biopsy reveals diffuse sheets of atypical, large B cells that have replaced the normal tissue architecture.  In situ hybridization of the tissue specimen is positive for Epstein-Barr virus.  Which of the following risk factors is most strongly associated with development of this patient's condition?


Definitions:

Lytic Infection

A type of viral infection that results in the destruction of the infected cell and its membrane, leading to the release of new viral particles.

Phage Components

Parts or structures that make up bacteriophages, viruses that infect and replicate within bacteria.

Assembly

The process of putting together a number of parts or components to form a complete unit, often referred to in manufacturing and software development.

Capsid

A capsid is the protein shell that encloses the genetic material of a virus, protecting it and aiding in its transmission between hosts.

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