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Epstein‐barr virus (EBV)‐related lymphoproliferative disorder with subsequent EBV‐negative T‐cell lymphoma
Author(s) -
Tao Qian,
Srivastava Gopesh,
Loke Shee Loong,
Liang Raymond H. S.,
Liu Yan Tat,
Ho Faith C. S.
Publication year - 1994
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910580107
Subject(s) - epstein–barr virus , lymphoma , immunostaining , biology , lytic cycle , lymph node , cd8 , pathology , virus , gene rearrangement , virology , immunology , medicine , antigen , immunohistochemistry , gene , biochemistry
A 58‐year‐old Chinese man presented initially with generalized lymphadenopathy, and lymph‐node biopsy showed disturbed architecture with preponderance of large B‐blasts mixed with numerous CD8 + T lymphocytes, consistent with an acute Epstein‐Barr virus(EBV) infection. Immunohistological and gene rearrangement studies confirmed the absence of clonal T or B cells. Polyclonal EBV with lytic infection was detected by Southern blot hybridization (SoBH). Expression of EBV proteins (EBNA2, LMP and ZEBRA) was detected in a proportion of cells by immunostaining. EBV‐lytic proteins EA‐D, VCA, MA were also detected in rare scattered cells. Double immunostaining showed that the LMP‐positive cells were of B and of T phenotype: 73% CD19 + , 26% CD2 + 23% CD3 + 8% CD4 + 17% CD8 + . After biopsy, there was spontaneous regression of lymph‐node enlargement, but lymphadenopathy recurred 8 months later, and the second lymph‐node biopsy showed T‐cell lymphoma, confirmed by detection of clonally rearranged T‐cell‐receptor beta‐chain gene. However, EBV genome could not be detected in the second biopsy by SoBH, in situ hybridization for EBV‐encoded EBER RNA, and immunostaining for EBNA2, LMP and ZEBRA was also negative. This case is of special interest because an EBV‐negative T‐cell lymphoma developed shortly after an acute episode of EBV‐related lymphoproliferation, even though many EBV‐positive T cells were detected during the acute episode. EBV was apparently not a direct cause of the lymphoma, but the close temporal association of the 2 lesions supports the hypothesis that EBV can act as a co‐factor in lymphomagenesis. © 1994 Wiley‐Liss, Inc.