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Epstein–Barr virus‐associated large B‐cell lymphoma transformation in marginal zone B‐cell lymphoma: a series of four cases
Author(s) -
Camacho Castañeda Francisca Inmaculada,
Dotor Ana,
Manso Rebeca,
Martín Paloma,
Prieto Pareja Elena,
Palomo Esteban Teresa,
García Vela José Antonio,
Santonja Carlos,
Piris Miguel A,
Rodríguez Pinilla Socorro María
Publication year - 2020
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.14101
Subject(s) - marginal zone , lymphoma , epstein–barr virus , virus , biology , b cell , cell of origin , marginal zone b cell lymphoma , biopsy , neoplastic transformation , pathology , cancer research , virology , gene , immunology , medicine , carcinogenesis , genetics , antibody
Aims To present four examples of clonally related Epstein–Barr virus (EBV)‐associated large‐cell transformation of marginal zone lymphoma (MZL) (of nodal, extranodal and splenic types), occurring 120, 11 and 5 months after the initial diagnosis in three instances, and concurrently in one case; and to discuss several interesting features of EBV infection. Methods and results Somatic mutations were detected by use of a customised panel for next‐generation sequencing and polymerase chain reaction studies of IgH in both low‐grade and high‐grade components of each case. In case 1, the initial biopsy of nodal MZL showed scattered EBV‐positive cells, which might constitute an indication of EBV‐induced progression. Case 2 showed heterogeneous EBV expression, a phenomenon attributable to loss of the EBV episomes during cell division, or to a secondary superinfection or reactivation of the virus. In case 3, p53 overexpression related to gene mutation and EBV‐encoded small RNAs were identified in the same neoplastic component. In case 4, the mucosa‐associated lymphoid tissue‐type MZL and the high‐grade component were identified concurrently in a patient previously treated with methotrexate for an autoimmune disorder. Conclusion These data suggest that the presence of EBV should be added to the list of potential markers to be analysed for MZL prognosis.