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Epstein-Barr virus-positive follicular lymphoma.

EB病毒阳性滤泡性淋巴瘤

Mackrides N,Campuzano-Zuluaga G,Maque-Acosta Y,Moul A,Hijazi N,Ikpatt FO,Levy R,Verdun RE,Kunkalla K,Natkunam Y,Lossos IS,Vega F,Chapman J
阅读:1277 Modern PathologyApr 2017; 30 (4): 472 - 629:519-529 

Abstract

Epstein-Barr virus (EBV) -associated follicular lymphoma is only rarely reported. Herein, we report the largest series analyzing prevalence and clinicopathologic characteristics of EBV-associated follicular lymphoma occurring in unselected cases. Out of 382 analyzed cases, 10 EBV-positive follicular lymphomas were identified (prevalence=2.6%, 95% confidence interval 1.3-4.0%). All EBV-positive follicular lymphomas showed EBV-encoded small RNA-positive lymphoma cells present in a follicular distribution. Of these, eight also had tissue available for testing of expression of latent membrane protein 1 (LMP1), out of which six (75%) were positive. There was a significant association with grades 3A-3B follicular lymphoma (P<0.0001) and CD30 expression (P=0.0002). EBV-positive follicular lymphomas were otherwise morphologically and immunophenotypically indistinguishable from EBV-negative cases of similar grade. Nine of the EBV-positive follicular lymphomas occurred in patients with no known history of immunosuppression, while one patient had a history of hydroxychloroquine administration for Sjögren's syndrome. The mean age in the EBV-positive and -negative follicular lymphomas was 56 (range 31-83 years) and 49 years (range 25-92 years), respectively, with no statistically significant difference. Seven of the patients with EBV-positive follicular lymphoma had additional biopsies from different time points available for review, all of which showed progression of disease in the form of progression of tumor grade. Five of these progressed to diffuse large B-cell lymphoma, one of which had tissue available for testing and was EBV-positive. Our findings suggest that EBV infection may have a role in lymphomagenesis and/or disease progression in a subset of follicular lymphomas, thereby expanding the spectrum of recognized EBV-associated B-cell lymphomas.

摘要

EB病毒(EBV)相关的滤泡性淋巴瘤很少有报道。在此,我们报道最大系列的病例,分析在未加选择病例的情况下EBV相关滤泡性淋巴瘤的发生率和临床病理特征。382例分析病例中,确诊10例EBV阳性滤泡性淋巴瘤(发生率= 2.6%,95%可信区间1.3-4.0 %)。所有EBV阳性滤泡性淋巴瘤病例均表现为EBV编码的小RNA阳性的淋巴细胞位于滤泡分布区。其中,8例有组织可供测试潜伏膜蛋白1(LMP1)的表达,其中6例(75%)阳性。级别3A-3B的滤泡性淋巴瘤(P<0.0001)和CD30的表达间有显著相关性(P = 0.0002)。EBV阳性滤泡性淋巴瘤与类似等级的EBV阴性病例在形态和免疫表型上不同。9例EB病毒阳性的滤泡性淋巴瘤发生在无任何已知免疫抑制病史的患者,1例病人因干燥综合征有羟化氯喹的用药史。EBV阳性和阴性的滤泡性淋巴瘤患者的平均年龄分别为56岁(范围31-83岁)和49岁(范围25-92岁),差异无统计学意义。7例EBV阳性滤泡性淋巴瘤患者有来自不同时间点、另外的活检可供复习,所有这些患者都以肿瘤分级进展的形式表现出疾病的进展。5例进展为弥漫性大B细胞淋巴瘤,其中1例可得到组织用于检测且EBV阳性。

我们的研究结果表明,作为滤泡性淋巴瘤的一个亚型,EBV感染可能在淋巴瘤发生和/或疾病进展中起作用,从而扩大已认识的EBV相关B细胞淋巴瘤的疾病谱。

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