Epstein-Barr virus (EBV) positive diffuse large B cell lymphoma of the elderly-Experience of a single center from Turkey
Epstein-Barr virus (EBV) positive diffuse large B cell lymphoma of the elderly-Experience of a single center from Turkey
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DOI：
10.1016/j.prp.2013.04.014
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发表时间：
2013-01-01
影响因子：
2.8
通讯作者：
Hekimgil, Mine
中科院分区：
文献类型：
--
作者：
Ozsan, Nazan;Cagirgan, Seckin;Hekimgil, Mine
在2008年WHO淋巴瘤分类中，老年人的EBV阳性弥漫性大B细胞淋巴瘤（DLBCL）被纳入为一个新的临时实体。我们的目的是评估在我们中心诊断为“老年人EBV阳性DLBCL”病例的形态学、免疫表型和临床特征，并将其与50岁以上的“EBV阴性DLBCL”患者进行比较。EB病毒早期RNA（EBER）原位杂交检测EB病毒状态。通过免疫组织化学，进行一组针对CD 10、Bcl-2、Bcl-6、IRF 4/MUM 1、CD 30和Ki 67的抗体。在149例年龄超过50岁的DLBCL患者中，没有任何已知的免疫缺陷或既往淋巴瘤病史，重新评估了8例符合标准的患者。5例患者为男性，3例为女性，中位年龄为67.6岁。四名患者表现为淋巴结受累，其他患者表现为骨和软组织、骨髓和脾脏浸润。5例病例显示主要为单形形态，1例还包含与多形亚型一致的局灶性区域; 3例患者显示多形浸润。当根据“Hans标准”分类时，5个是非GCB，3个是GCB细胞表型。所有具有多态性形态的病例均显示为非GCB细胞表型，并且均表达IRF 4/MUM 1。2例患者死于疾病，4例患者存活并在R-CHOP治疗后完全缓解，2例患者最近被确诊。与EBV阴性组相比，没有可靠的形态学和免疫组化特征表明EBV阳性。因此，EBER原位杂交分析对于鉴别“老年人EB病毒阳性DLBCL”是必要的，需要进一步的研究来充分了解这种疾病的细节，这可能会导致新的治疗方式。(C)2013 Elsevier GmbH. All rights reserved.
In the 2008 WHO lymphoma classification, 'EBV-positive diffuse large B cell lymphoma (DLBCL) of the elderly is included as a new provisional entity. We aimed to evaluate the morphological, immunophenotypic, and clinical characteristics of the cases diagnosed as 'EBV-positive DLBCL of the elderly' in our center and compared them with the 'EBV-negative DLBCL' patients older than 50 years of age. EBV status was detected by Epstein-Barr early RNA (EBER) in situ hybridization analysis. By immunohistochemistry, a panel of antibodies for CD10, Bcl-2, Bcl-6, IRF4/MUM1, CD30, and Ki67 was performed. Out of 149 DLBCL patients older than 50 years, without any known history of immunodeficiency or prior lymphoma, eight patients who fulfill the criteria were re-evaluated. Five patients were male and three were female, with a median age of 67.6 years. Four patients presented with nodal involvement; others presented with bone and soft tissue, bone marrow, and spleen infiltrations. Five cases revealed predominantly monomorphic morphology, one also contained focal areas consistent with polymorphous subtype; and three patients revealed a polymorphous infiltrate. When classified according to 'Hans criteria', five were non-GCB, and three were of the GCB cell phenotype. All cases with polymorphous morphology were revealed to be of the non-GCB cell phenotype, and all expressed IRF4/MUM1. Two patients died with disease, four patients are alive and in complete remission following R-CHOP therapy, and two patients have just recently been diagnosed.When compared with the EBV-negative group, there are no reliable morphological and immunohistochemical features indicating EBV positivity. Therefore, EBER in situ hybridization analysis is necessary to identify 'EBV-positive DLBCL of the elderly'.Further studies are needed to fully understand the details of this disease, which can lead to new treatment modalities. (C) 2013 Elsevier GmbH. All rights reserved.