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A pathologic study of Hodgkin's disease in Korea and its association with the Epstein‐Barr virus infection
Author(s) -
Huh Jooryung,
Park Changsoo,
Juhng Sangwoo,
Kim Chi Eun,
Poppema Sibrand,
Kim Chulwoo
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960301)77:5<949::aid-cncr22>3.0.co;2-2
Subject(s) - nodular sclerosis , medicine , incidence (geometry) , virus , stage (stratigraphy) , lymphocyte , epstein–barr virus , disease , pathology , immunohistochemistry , in situ hybridization , gastroenterology , lymphoma , immunology , hodgkin lymphoma , biology , gene , gene expression , paleontology , biochemistry , physics , optics
BACKGROUND The incidence of Hodgkin's disease (HD) in Korea and other Asian countries is much lower than in western countries and its association with the Epstein–Barr virus has not been well characterized. METHODS We evaluated the clinical, morphologic, and immunohistochemical features of 87 patients with Hodgkin's disease and also analyzed patients for Epstein–Barr virus (EBV) using in situ hybridization for EBV DNA, RNA, and latent membrane protein (LMP1). RESULTS There were 68 males and 19 females, with a mean age of 38 years. Mixed cellularity was the most prevalent subtype. Expression of EBV RNA (EBER:EBV‐encoded RNA) was detected in 60 of 87 cases (69%): 1 of 1 (100%) with lymphocyte predominance, nodular; 4 of 7 (57%) with lymphocyte predominance, diffuse; 10 of 17 (59%) with nodular sclerosis; 38 of 51 (75%) with mixed cellularity; and 7 of 11 (64%) with lymphocyte depletion. Positivity was higher in advanced clinical stages; 4 of 7 patients (57%) with Stage I; 6 of 12 patients (50%) with Stage II; 7 of 9 patients (75%) with Stage III; and 5 of 5 patients (100%) with Stage IV HD EBV DNA was detected in 9 of 25 cases tested (36%). LMP1 was seen in 39 of 87 cases (45%). EBER and LMP1 positivity were higher in children and older adults than in adults aged between 15–50 years. Immediate early mRNAs (BHLF:Bam H‐fragment, lower strand frame) was seen in a single patient. CONCLUSIONS HD in Korea showed a high incidence of mixed cellularity subtype and a high prevalence of EBV. EBV was detected in all subtypes, including a case of nodular lymphocytic predominance, and in all age groups, and showed correlation with mixed cellularity subtype and higher clinical stage. The expression of EBER and LMP were more frequently seen in children and older adults, suggesting a lowered immune surveillance in those age groups or a different pathophysiology of HD among different age groups. Cancer 1996;77:949‐55.