Clinicopathologic and molecular biologic study of borderline lymphoproliferative disorders

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Malignant lympomas and its related lymphoproliferative disorders reveal the broad clinicopathologic, biologic and endemic spectrum. In several recent years, much interest is focused on the borderline lesions, e.g., T-zone dysplasia, progressive transformation of germinal center, and Epstein-Barr virus (EBV) - or autoimmunerelated lesions frequently encountered in the immunocompremised hosts and elderly patients. The aim of the present study was to recognize the disease spectrum laying between these borderline lesions and malignant lymphomas. A previously undescribed type of EBV-associated lymphoprliferative disorder featured by the rapid pregression of the disease has been identified in the present study (manuscipt in contribution). In these cases, monoclonal integration of EBV genome was domenstrated. However, it was currently unclear whether they were bona fide neoplasms or reactive lesions, suggesting the difficulty in their distinction from the pathologic and biologic viewpoints. On the other hand, several cases, which were currently ill-defined and tentatively diagnosed as borderline lesions without evidence of the clonal preliferation of any cells, has been encountered in the elderly patients. These cases persued the indolent clinical course over the time of the present study, and their clinicopathologic and biologic nature remains to be elucidated. The present data suggest that the borderline lymphoproliferative disorders might be regarded as the desintegration of the immunesystem more or less induced by pathologic agents. Futher investigtion is needed.