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Tanaka S, Nagata N, Mine S, Igari T, Kobayashi T, Sugihara J, Honda H, Teruya K, Kikuchi Y, Oka S, Uemura N. Endoscopic appearance of AIDS-related gastrointestinal lymphoma with c- MYC rearrangements: Case report and literature review. World J Gastroenterol 2013; 19:4827-4831. [PMID: 23922484 PMCID: PMC3732859 DOI: 10.3748/wjg.v19.i29.4827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 05/12/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the highly active anti-retroviral therapy (HAART) era. Recently, rearrangement of MYC is associated with poor prognosis in patients with diffuse large B-cell lymphoma. Here, we report a rare case of gastrointestinal (GI)-ARL with MYC rearrangements and coinfected with Epstein-Barr virus (EBV) infection presenting with various endoscopic findings. A 38-year-old homosexual man who presented with anemia and was diagnosed with an human immunodeficiency virus infection for the first time. GI endoscopy revealed multiple dish-like lesions, ulcerations, bloody spots, nodular masses with active bleeding in the stomach, erythematous flat lesions in the duodenum, and multiple nodular masses in the colon and rectum. Magnified endoscopy with narrow band imaging showed a honeycomb-like pattern without irregular microvessels in the dish-like lesions of the stomach. Biopsy specimens from the stomach, duodenum, colon, and rectum revealed diffuse large B-cell lymphoma concomitant with EBV infection that was detected by high tissue EBV-polymerase chain reaction levels and Epstein-Barr virus small RNAs in situ hybridization. Fluorescence in situ hybridization analysis revealed a fusion between the immunoglobulin heavy chain (IgH) and c-MYC genes, but not between the IgH and BCL2 loci. After 1-mo of treatment with HAART and R-CHOP, endoscopic appearance improved remarkably, and the histological features of the biopsy specimens revealed no evidence of lymphoma. However, he died from multiple organ failure on the 139th day after diagnosis. The cause of his poor outcome may be related to MYC rearrangement. The GI tract involvement in ARL is rarely reported, and its endoscopic findings are various and may be different from those in non-AIDS GI lymphoma; thus, we also conducted a literature review of GI-ARL cases.
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MESH Headings
- Adult
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antiretroviral Therapy, Highly Active
- Biopsy
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Endoscopy, Gastrointestinal
- Fatal Outcome
- Gastrointestinal Neoplasms/drug therapy
- Gastrointestinal Neoplasms/genetics
- Gastrointestinal Neoplasms/pathology
- Gastrointestinal Neoplasms/virology
- Gene Rearrangement
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/virology
- Predictive Value of Tests
- Prednisone/administration & dosage
- Proto-Oncogene Proteins c-myc/genetics
- Rituximab
- Time Factors
- Treatment Outcome
- Vincristine/administration & dosage
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Nakatsuka SI, Kimura H, Nagano T, Fujita M, Kanda T, Iwata T, Hashimoto K. Self-limited effusion large B-cell lymphoma: two cases of effusion lymphoma maintaining remission after drainage alone. Acta Haematol 2013; 130:217-21. [PMID: 23816805 DOI: 10.1159/000350482] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 02/24/2013] [Indexed: 11/19/2022]
Abstract
We report two cases of human herpesvirus-8 (HHV-8)-negative large B-cell lymphoma involving pericardial and/or pleural effusion that regressed after drainage alone. Case 1 is a 70-year-old man showing massive pericardial effusion. Cytology of the drained effusion showed monotonous infiltration of CD3-, CD20+, CD79a+, and CD138- large B-cells. Monoclonality was shown by Southern blot analysis. Case 2 is a 70-year-old man with massive pericardial and bilateral pleural effusion. Cytology of pericardial effusion showed infiltration of CD20+, CD45RO-, CD138-, immunoglobulin lambda chain+, and kappa chain- large B cells. In both cases, effusion resolved after drainage and no relapse has been observed. HHV-8 was not demonstrated in either case. Clinical presentation of our two cases resembled primary effusion lymphoma (PEL), but cytomorphology, immunophenotype, and prognosis were clearly distinct from those of PEL. HHV-8-negative effusion lymphomas might include prognostically favorable self-limited tumors that could regress without any cytotoxic therapy.
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MESH Headings
- Aged
- Antigens, CD/blood
- Heart Neoplasms/blood
- Heart Neoplasms/pathology
- Heart Neoplasms/therapy
- Heart Neoplasms/virology
- Herpesviridae Infections
- Herpesvirus 8, Human
- Humans
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, Primary Effusion/blood
- Lymphoma, Primary Effusion/pathology
- Lymphoma, Primary Effusion/therapy
- Lymphoma, Primary Effusion/virology
- Male
- Neoplasm Proteins/blood
- Pericardial Effusion/blood
- Pericardial Effusion/pathology
- Pericardial Effusion/therapy
- Pericardial Effusion/virology
- Pleural Effusion, Malignant/blood
- Pleural Effusion, Malignant/pathology
- Pleural Effusion, Malignant/therapy
- Pleural Effusion, Malignant/virology
- Remission Induction
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53
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Ando M, Sato Y, Takata K, Nomoto J, Nakamura S, Ohshima K, Takeuchi T, Orita Y, Kobayashi Y, Yoshino T. A20 (TNFAIP3) deletion in Epstein-Barr virus-associated lymphoproliferative disorders/lymphomas. PLoS One 2013; 8:e56741. [PMID: 23418597 PMCID: PMC3572056 DOI: 10.1371/journal.pone.0056741] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/14/2013] [Indexed: 02/06/2023] Open
Abstract
A negative regulator of the nuclear factor (NF)-κB pathway, A20 (TNFAIP3), is inactivated in several types of lymphomas; particularly in diffuse large B-cell lymphoma (DLBCL), classical Hodgkin's lymphoma, and extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue. These findings suggest that the NF-κB activation is related to A20 inactivation. Recently, A20 inactivation has also been observed in Epstein-Barr virus (EBV)-related lymphomas; however, this occurrence has not been well investigated. Moreover, NF-κB is a key molecule in activated B-cell-like (ABC)-type DLBCL; EBV-associated DLBCL is of the ABC type. Therefore, we focused on A20 deletions in EBV-associated lymphoproliferative disorders/lymphomas. Using fluorescent in situ hybridization analysis, A20 deletions were identified in 4 of 13 samples from patients with pyothorax-associated lymphoma (PAL) (31%), 3 of 20 samples from nasal-type NK/T cell lymphomas (NKTLs) (15%), 1 of 8 samples of EBV-positive DLBCL of the elderly (DLBCL-e) (13%), but not in any of the 11 samples from individuals with methotrexate-related lymphoproliferative disorder (MTX-LPD) (0%). Among the samples with A20 deletions, EBV latent membrane protein 1 (LMP-1) expression was detected in all 4 of the PAL samples with A20 deletions and in the DLBCL-e sample with an A20 deletion, but not in any of the 3 NKTL samples. This finding indicated that A20 deletions were not directly related to the EBV latency pattern of lymphomas, although such deletions might be related to the diagnostic category. Immunohistologically, the A20 protein was absent in 2 (15%) of the 13 PAL samples, 1 (9%) of 11 MTX-LPD samples, and in none of the 20 NKTL (0%) or 8 DLBCL-e samples. In conclusion, A20 deletion and/or dysfunctional expression are frequently associated with PALs, and A20 abnormalities may be related to the pathogenesis of PAL.
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MESH Headings
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Empyema, Pleural/complications
- Epstein-Barr Virus Infections/genetics
- Epstein-Barr Virus Infections/metabolism
- Epstein-Barr Virus Infections/virology
- Epstein-Barr Virus Nuclear Antigens/metabolism
- Gene Deletion
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/metabolism
- Herpesvirus 4, Human/physiology
- Host-Pathogen Interactions
- Humans
- Immunohistochemistry
- In Situ Hybridization
- In Situ Hybridization, Fluorescence
- Intracellular Signaling Peptides and Proteins/genetics
- Intracellular Signaling Peptides and Proteins/metabolism
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/metabolism
- Lymphoma, B-Cell/virology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/metabolism
- Lymphoma, Non-Hodgkin/virology
- Lymphoproliferative Disorders/genetics
- Lymphoproliferative Disorders/metabolism
- Lymphoproliferative Disorders/virology
- NF-kappa B/metabolism
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- RNA, Viral/genetics
- Tumor Necrosis Factor alpha-Induced Protein 3
- Viral Matrix Proteins/metabolism
- Viral Proteins/metabolism
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Zhao XF, Zhao MY, Chai L, Kukuruga D, Tan M, Stass SA. Amplified RPS6KB1 and CDC2 genes are potential biomarkers for aggressive HIV+/EBV+ diffuse large B-cell lymphomas. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:148-154. [PMID: 23330000 PMCID: PMC3544236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 11/27/2012] [Indexed: 06/01/2023]
Abstract
RPS6KB1 encodes p70S6K/p85S6K, which plays a role in the PI3K/Akt/mTOR signal transduction pathway. CDC2 gene encodes cdc2, which is critical for G2/M cell cycle progression. We had previously shown that amplified RPS6KB1 and CDC2 are commonly detected in the EBV+ diffuse large B-cell lymphoma (DLBCL) in HIV patients. In current study, we further evaluated the amplified RPS6KB1 and CDC2 genes in 12 HIV-related aggressive B-cell lymphomas and 10 non-HIV-related DLBCL using real time quantitative PCR. The cases were divided into 4 groups: 1) HIV-/EBV-; 2) HIV-/EBV+; 3) HIV+/EBV-; and 4) HIV+/EBV+. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to assess the ability of each gene to distinguish non-HIV+/EBV+ cases from HIV+/EBV+ cases. The AUC was estimated to be 0.76 for RPS6KB1 and 0.74 for CDC2 by using the Mann-Whitney statistic. Amplified RPS6KB1 and CDC2 genes were more frequently detected in common variants of DLBCL associated with HIV infection. Taken together, amplified RPS6KB1 and CDC2 are potential biomarkers for the aggressive DLBCL, particularly in HIV+/EBV+ patients. This study also suggests that the HIV+/EBV+ aggressive DLBCL could be potentially treated by targeting RPS6KB1 and CDC2 genes.
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MESH Headings
- Biomarkers, Tumor/genetics
- CDC2 Protein Kinase
- Cell Division/genetics
- Cyclin B/genetics
- Cyclin-Dependent Kinases
- Epstein-Barr Virus Infections/complications
- G2 Phase/genetics
- HIV Infections/complications
- Humans
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- ROC Curve
- Ribosomal Protein S6 Kinases, 70-kDa/genetics
- Signal Transduction/genetics
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55
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Malikhova OA, Tumanian AO, Ugniadze GV, Storozhakov GI, Lepkov SV. [Concurrent development of non-Hodgkin lymphoma and hepatocellular carcinoma in patient with chronic hepatitis C]. EKSPERIMENTAL'NAIA I KLINICHESKAIA GASTROENTEROLOGIIA = EXPERIMENTAL & CLINICAL GASTROENTEROLOGY 2013:44-48. [PMID: 24772876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
MESH Headings
- Aged
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/virology
- Fatal Outcome
- Hepatitis C, Chronic/drug therapy
- Hepatitis C, Chronic/pathology
- Hepatitis C, Chronic/virology
- Humans
- Liver Neoplasms/drug therapy
- Liver Neoplasms/pathology
- Liver Neoplasms/virology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/virology
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56
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Nichele I, Zamò A, Bertolaso A, Bifari F, Tinelli M, Franchini M, Stradoni R, Aprili F, Pizzolo G, Krampera M. VR09 cell line: an EBV-positive lymphoblastoid cell line with in vivo characteristics of diffuse large B cell lymphoma of activated B-cell type. PLoS One 2012; 7:e52811. [PMID: 23285191 PMCID: PMC3528718 DOI: 10.1371/journal.pone.0052811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 11/21/2012] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND small B-cell neoplasms can show plasmacytic differentiation and may potentially progress to aggressive lymphoma (DLBCL). Epstein-Barr virus (EBV) infection may cause the transformation of malignant cells in vitro. DESIGN AND METHOD we established VR09 cell line with plasmacytic differentiation, obtained from a case of atypical, non-CLL B-cell chronic lymphoproliferative disease with plasmacytic features. We used flow cytometry, immunohistochemistry, polymerase chain reaction, cytogenetic analysis and florescence in situ hybridization in the attempt at thoroughly characterizing the cell line. We showed VR09 tumorigenic potential in vivo, leading to the development of activated DLBCL with plasmacytic features. RESULTS VR09 cells displayed plasmacytic appearance and grew as spherical tumors when inoculated subcutaneously into immunodeficient Rag2(-/-) γ-chain(-/-) mice. VR09 cell line and tumors displayed the phenotype of activated stage of B cell maturation, with secretory differentiation (CD19+ CD20+ CD79a+ CD79b+/- CD138+ cyclin D1- Ki67 80% IgM+ IgD+ MUM1+ MNDA+ CD10- CD22+ CD23+ CD43+ K+, λ- Bcl2+ Bcl6-) and they presented episomal EBV genome, chromosome 12 trisomy, lack of c-MYC rearrangement and Myd88 gene mutation, presence of somatic hypermutation in the VH region, and wild-type p53. CONCLUSION This new EBV-positive cell line may be useful to further characterize in vivo activated DLBCL with plasmacytic features.
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MESH Headings
- Aged
- Animals
- CARD Signaling Adaptor Proteins/genetics
- CD79 Antigens/genetics
- Cell Cycle
- Cell Line, Tumor
- Disease Models, Animal
- Guanylate Cyclase/genetics
- Herpesvirus 4, Human/genetics
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotype
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Mice
- Mice, Knockout
- Mutation
- Myeloid Differentiation Factor 88/genetics
- Transplantation, Heterologous
- Tumor Suppressor Protein p53/genetics
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57
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Bhamidipati PK, Jabbour E, Konoplev S, Estrov Z, Cortes J, Daver N. Epstein-Barr virus-induced CD30-positive diffuse large B-cell lymphoma in a patient with mixed-phenotypic leukemia treated with clofarabine. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2012; 13:342-6. [PMID: 23246163 DOI: 10.1016/j.clml.2012.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 09/28/2012] [Accepted: 10/01/2012] [Indexed: 11/19/2022]
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58
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Chao C, Silverberg MJ, Martínez-Maza O, Chi M, Abrams DI, Haque R, Zha HD, McGuire M, Xu L, Said J. Epstein-Barr virus infection and expression of B-cell oncogenic markers in HIV-related diffuse large B-cell Lymphoma. Clin Cancer Res 2012; 18:4702-12. [PMID: 22711707 PMCID: PMC3846529 DOI: 10.1158/1078-0432.ccr-11-3169] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE Epstein-Barr virus (EBV)-mediated lymphomagenesis in the setting of HIV infection has been widely accepted. However, little is known about how EBV impacts prognosis. We investigated the hypothesis that EBV infection is associated with expression of specific B-cell oncogenic markers in HIV-related diffuse large B-cell lymphoma (DLBCL) and examined the prognostic use of detecting EBV infection. EXPERIMENTAL DESIGN HIV-related DLBCL cases diagnosed between 1996 and 2007 within Kaiser Permanente California were identified. Immunohistochemical staining was used to analyze the expression of selected markers that are cell-cycle regulators, B-cell activators, and antiapoptotic proteins among others. EBV infection was determined by in situ hybridization of EBV RNA. Correlations between EBV and marker expression were examined using Spearman correlation coefficient. The prognostic use of EBV status was examined in multivariable Cox model adjusting for International Prognostic Index (IPI). Receiver-operating characteristics (ROC) analysis was used to evaluate improvement in model discrimination. RESULTS Seventy HIV-related DLBCL cases were included (31% EBV±). EBV+ tumor was associated with increased expression of BLIMP1 and CD30 and reduced expression of BCL6 and LMO2. EBV+ tumor was independently associated with elevated 2-year overall mortality [HR, 3.3; 95% confidence interval (CI), 1.6-6.6]. Area under the ROC curve showed improved model discrimination when incorporating tumor EBV status with IPI in the prediction model [0.65 vs. 0.74 (IPI only)]. CONCLUSION Our results suggest that EBV infection was associated with expression of several tumor markers that are involved in the NF-κB pathway and that detecting tumor EBV status may have prognostic use in HIV-related DLBCLs.
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MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Acquired Immunodeficiency Syndrome/metabolism
- Acquired Immunodeficiency Syndrome/pathology
- Adaptor Proteins, Signal Transducing/metabolism
- Apoptosis
- B7-1 Antigen/metabolism
- Cell Cycle Proteins/metabolism
- DNA-Binding Proteins/metabolism
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/metabolism
- Epstein-Barr Virus Infections/pathology
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 4, Human/pathogenicity
- Humans
- In Situ Hybridization
- Kaplan-Meier Estimate
- Ki-1 Antigen/metabolism
- LIM Domain Proteins/metabolism
- Lymphoma, AIDS-Related/complications
- Lymphoma, AIDS-Related/metabolism
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/virology
- NF-kappa B/metabolism
- Positive Regulatory Domain I-Binding Factor 1
- Prognosis
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-bcl-6
- Repressor Proteins/metabolism
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59
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Smeltzer JP, Viswanatha DS, Habermann TM, Patnaik MM. Secondary Epstein-Barr virus associated lymphoproliferative disorder developing in a patient with angioimmunoblastic T cell lymphoma on vorinostat. Am J Hematol 2012; 87:927-8. [PMID: 22718468 DOI: 10.1002/ajh.23271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 05/02/2012] [Accepted: 05/10/2012] [Indexed: 11/08/2022]
Abstract
Ebstein-Barr Virus (EBV)-related lymphoproliferative disorders primarily occur in the setting of immunosuppression, most commonly after solid organ transplantation. The frequency depends on the degree of immunosuppression and the specific organ transplanted, but can be as high as 3–9% in heart or lung transplant patients. Less frequent outside of the transplant setting, EBV-related lymphoproliferative disorders classified as other iatrogenic immunodeficiency associated lymphoproliferative disorders in the WHO Classification, which are different than iatrogenically related lymphomas supervening on hematological malignancies, have been associated with other immunosuppressive therapies such as 6-Mercaptopurine, azathioprine, or alemtuzumab. These disorders have also been reported to develop spontaneously in patients with T cell lymphomas (angioimmunoblastic and peripheral T cell NOS). Here we report the case of a patient with an angioimmunoblastic T cell lymphoma on therapy with vorinostat who developed an EBV related B-cell lymphoproliferative disorder involving bilateral adrenal glands. Angioimmunoblastic T cell lymphoma is associated with severe immunodeficiency and risk for opportunistic infections. This immune dysregulation has been implicated in its association with EBV related lymphoproliferative disorders. In this patient, vorinostat therapy also appears to be linked to the development of an EBV-related lymphoproliferative disorder.
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MESH Headings
- Adrenal Gland Neoplasms/diagnosis
- Adrenal Gland Neoplasms/drug therapy
- Adrenal Gland Neoplasms/etiology
- Adrenal Gland Neoplasms/virology
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Epstein-Barr Virus Infections/diagnosis
- Epstein-Barr Virus Infections/drug therapy
- Epstein-Barr Virus Infections/etiology
- Female
- Humans
- Hydroxamic Acids/administration & dosage
- Hydroxamic Acids/adverse effects
- Hydroxamic Acids/therapeutic use
- Immunoblastic Lymphadenopathy/diagnosis
- Immunoblastic Lymphadenopathy/drug therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/drug therapy
- Middle Aged
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/virology
- Treatment Outcome
- Vorinostat
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60
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Hay AE, Meyer RM. Hepatitis B, rituximab, screening, and prophylaxis: effectiveness and cost effectiveness. J Clin Oncol 2012; 30:3155-7. [PMID: 22891267 DOI: 10.1200/jco.2012.43.7509] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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61
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Nose K, Oki T, Banno E, Sugimoto K, Nishioka T, Ochiai K, Maekura S. The efficacy of EBER in situ hybridization (ISH) stain in PTLD (malignant diffuse large B-cell lymphoma) about 4 years after ABO-incompatible kidney transplantation: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2012; 5:359-362. [PMID: 22670181 PMCID: PMC3365825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 04/11/2012] [Indexed: 06/01/2023]
Abstract
Post-transplant lymphoproliferative disease (PTLD) is a well-known late complication of organ transplantation which incidence has increased after the introduction of more powerful immunosuppressive agents. A 58-year-old man performed ABO-incompatible living kidney transplantation in June, 2008. At 3 years and 9 months after the transplantation, the patient complained of general fatigue and dyspnea and was hospitalized with renal dysfunction. The clinical data in hospital showed acute rejection, but soluble IL-II exceeded 21700U/ml, and HE staining kidney graft showed a massive infiltration of atypical lymphocytes. Atypical lymphocytes were positive for L-26 and negative for CD3 immunochemical stein, and the EBER in situ hybridization stain for EBV was negative in renal graft. We diagnosed diffuse large B-cell lymphoma in the kidney graft. However, he died due to multiple organ failure (MOF). We described a fatal case of diffuse large B-cell lymphoma without EBV infection occurring 3 years 9 months after ABO-incompatible kidney transplantation. Unfortunately, post-mortem autopsy using EBER-ISH stain does not show whether EB virus infection was a cause.
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62
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Shimura T, Sugisaki Y, Fukino K, Node Y, Teramoto A, Kawamoto M. Detection of Epstein-Barr virus DNA and expression of CD30 antigen in primary anaplastic diffuse large B-cell lymphoma of the brain. Brain Tumor Pathol 2012; 18:161-5. [PMID: 11908874 DOI: 10.1007/bf02479431] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe a case of primary anaplastic diffuse large-cell lymphoma arising in the central nervous system (CNS). Primary CD30-positive anaplastic diffuse large B-cell lymphoma of the brain is very rarely reported. Given that this tumor is immunohistochemically heterogeneous, polymerase chain reaction (PCR) and Epstein-Barr virus (EBV) analysis of tumor DNA are essential techniques for early and accurate histological diagnosis in these CD30-positive cerebral lymphoma cases. We report an early CD30- and EBV-positive anaplastic diffuse large B-cell lymphoma in the CNS that was diagnosed not only from the immunohistochemical study and MRI findings, but also from the genotype confirmations. This tumor was documented to have EBV episomes of monoclonal origin by PCR analysis of immunoglobulin gene rearrangement.
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63
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Abenavoli L, Pennacchia I, Stigliano E, Carbone A, Vecchio FM, Arena V. Aggressive large B-cell lymphoma in a systemic lupus erythematosus patient with chronic active Epstein-Barr virus infection: a case report. Int J Immunopathol Pharmacol 2012; 24:1083-6. [PMID: 22230415 DOI: 10.1177/039463201102400427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A link between Epstein-Barr Virus (EBV) infection, systemic lupus erythematosus (SLE) and non-Hodgkin's lymphoma (NHL) has been recently reported in literature. Here we report a case of diffuse large B-cell lymphoma (DLBCL) with a particularly aggressive clinical course in an SLE patient with EBV infection. A 49-year-old woman with a long history of SLE was admitted to the Department of Experimental and Clinical Medicine and dramatically died a few hours later. The autopsy described no evidence of active lymphoproliferative disorder. Instead, histological examination demonstrated an atypical lymphocitic proliferation in lymph node, kidneys, pericardium and uterus. Immunoistochemically, the lymphomatous cells were positive with CD19, CD20, CD22 and CD79a, which was consistent with a DLBCL. The cells were also reactive to EBV markers, indicating the possible role of previous EBV infection in DLBCL pathogenesis.
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MESH Headings
- Autopsy
- Chronic Disease
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/immunology
- Fatal Outcome
- Female
- Humans
- Immunohistochemistry
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/immunology
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Middle Aged
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64
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Ohata K, Iwaki N, Kotani T, Kondo Y, Yamazaki H, Nakao S. An Epstein-Barr virus-associated leukemic lymphoma in a patient treated with rabbit antithymocyte globulin and cyclosporine for hepatitis-associated aplastic anemia. Acta Haematol 2012; 127:96-9. [PMID: 22178718 DOI: 10.1159/000333609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 09/25/2011] [Indexed: 11/19/2022]
Abstract
Lymphoproliferative disorders (LPDs) are generally caused by uncontrolled B-cell proliferation induced by the Epstein-Barr virus (EBV) in the setting of impaired EBV-specific T-cell immunity, particularly when there is pharmacological immunosuppression including antithymocyte globulin. We herein present an unusual case of EBV associated with LPD (EBV-LPD) in which LPD occurred 3 weeks after the use of rabbit antithymocyte globulin administered for severe hepatitis-associated aplastic anemia; the patient died of fulminant leukemic lymphoma 5 days after the onset. We also review the pertinent literature on EBV-LPD after immunosuppressive therapy and document the efficacy of EBV viral load monitoring and the need for preemptive therapy.
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Sakata S, Hamamoto J, Sugahara K, Ichiyasu H, Saita N, Iyama K, Kohrogi H. [A case of Epstein-Barr virus-positive diffuse large B-cell lymphoma in an elderly person with a necrotizing pulmonary bulky mass]. NIHON KOKYUKI GAKKAI ZASSHI = THE JOURNAL OF THE JAPANESE RESPIRATORY SOCIETY 2011; 49:833-837. [PMID: 22171487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 52-year-old man presented with a pulmonary bulky mass, fever and cough. Chest CT showed a necrotizing bulky mass 10 cm in diameter in the right lung lower lobe. Transbronchial biopsy and CT-guided biopsy of the tumor and endobronchial ultrasound-guided transbronchial needle aspiration of the right hilar lymph node did not yield a definitive diagnosis, but the histological findings showed necrosis. We performed CT-guided biopsy of the part of the lesion where a high uptake of FDG-PET was observed. The histological diagnosis was diffuse large B-cell lymphoma. The immunohistochemical findings were positive for Epstein-Barr virus (EBV). Because the patient was more than 50 years old and had no underlying diseases, he was given a diagnosis of EBV-positive diffuse large B-cell lymphoma of an elderly patient. The pulmonary manifestation of this disease as a bulky tumor is extremely rare. In spite of the presence of a bulky pulmonary tumor, the EBV-positive diffuse large B-cell lymphoma contained necrotizing tissue, and it was difficult to obtain tissue specimens for histological examination.
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Xu FP, Liu YH, Zhuang HG, Luo DL, Li L, Zhang F, Luo XL, Du X, Li WY, Chen Q. [Clinicopathological features of Epstein-Barr virus-positive diffuse large B-cell lymphoma in elderly]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2011; 40:616-621. [PMID: 22177246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate the clinicopathological features of EB virus positive diffuse large B-cell lymphomas (EBV + DLBCL) of the elderly. METHODS Four hundred and ninety-six cases of DLBCLs were retrospectively studied by in situ hybridization (ISH) to detect the EBV in tumor cells, and by immunohistochemistry to evaluate the expression of CD10, CD20, CD30, CD79a, bcl-6, bcl-2, MUM-1, CD5, CD3, TIA-1 and Ki-67 protein. Their clinicopathological correlations were analyzed. RESULTS Of the 59 cases of EBV + DLBCL, 48 cases were EBV positive. The median age of these EBV + DLBCLs was 73 years with male predominance (1.4:1). There were 11 cases with nodal presentation only, 18 cases with extra-nodal presentation and 19 cases with both lymph nodal and extra-nodal involvements, whereas about one third cases with more than one extra-nodal involvement. Thirty-five patients presented with advanced disease (Ann Arbor stage III/IV). A performance status was available in 36 cases and 5 cases had performance status of more than 1. Seven of 30 patients were found with high lactate dehydrogenase value (more than twice of the normal). An IPI-score was calculated in 30 cases and 18 cases had an intermediate/high IPI-score (3-5). The median survival for these patients was 35 months. Morphologically, EBV + DLBCLs of the elderly generally showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components including small lymphocytes, plasma cells, histiocytes, and epithelioid cells. These tumor cells were frequently characterized by a broad range of B-cell maturation, containing centroblasts, immunoblasts, and Hodgkin- and Reed-Sternberg (HRS)-like giant cells. The study cohort was further morphologically divided into large cell lymphoma subtypes (n = 33) and polymorphic lymphoma subtypes (n = 14) and one case with mixed subtype. Immunohistochemical studies showed that tumor cells were positive for CD20 (47/48) and/or CD79a (45/45) in almost cases. Tumor cells were MUM-1-positive in the majority of the cases (44/47) and were stained for CD10 or bcl-6 in a few cases. Expression of bcl-2 and CD30 was observed in 80.0% (28/35) and 28.9% (11/38) cases, respectively, and most of the cases (33/39) had a high proliferative index (by Ki-67 with a 50% cut-off point). Compared with other EBV + DLBCLs, except the older age and low frequency of bcl-6 staining, no other significant differences were observed in EBV + DLBCLs of the elderly. CONCLUSIONS EBV + DLBCLs of the elderly constitute a distinct clinicopathologic subtype of DLBCL, although many clinical and histological features with EBV + lymphomas are similar with that of younger ages. Differential diagnosis from other types of lymphomas should also be considered.
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MESH Headings
- Aged
- Aged, 80 and over
- Antigens, CD20/metabolism
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- CD79 Antigens/metabolism
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Epstein-Barr Virus Infections
- Female
- Follow-Up Studies
- Herpesvirus 4, Human/isolation & purification
- Humans
- Interferon Regulatory Factors/metabolism
- Ki-1 Antigen/metabolism
- L-Lactate Dehydrogenase/blood
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Neoplasm Staging
- Prednisone/therapeutic use
- Retrospective Studies
- Survival Rate
- Vincristine/therapeutic use
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Beltran BE, Castillo JJ, Morales D, de Mendoza FH, Quinones P, Miranda RN, Gallo A, Lopez-Ilasaca M, Butera JN, Sotomayor EM. EBV-positive diffuse large B-cell lymphoma of the elderly: a case series from Peru. Am J Hematol 2011; 86:663-7. [PMID: 21761432 DOI: 10.1002/ajh.22078] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
EBV-positive diffuse large B-cell lymphoma (DLBCL) of the elderly is an entity recently included in the WHO classification of lymphoid tumors. We have reviewed our experience and clinical outcomes of this distinct subtype of DLBCL. Between 2002 and 2009, cases of DLBCL were identified from medical records of the Hospital Nacional Edgardo Rebagliati Martins in Lima, Peru, and underwent pathological evaluation including immunohistochemistry for CD20, CD10, bcl-6, MUM1/IRF4, and EBV-encoded RNA in situ hybridization. Clinical data were gathered, tabulated, and reported descriptively. Survival analyses were performed using Kaplan-Meier estimates. Out of 199 cases of DLBCL, 28 cases of EBV-positive DLBCL of the elderly were identified. The median age was 75 years with male predominance (1.5:1). B-symptoms were present in 43%, advanced stage in 50% and International Prognostic Index (IPI) score > 2 in 57% of patients; 68% of patients had a nongerminal center (NGC) phenotype. The complete response rates to R-CHOP and CHOP were 63% and 33%, respectively. The median overall survival (OS) for the group was 5 months. In the univariate analysis, age ≥70 years, lymphocyte count <1.0 × 10(9) /L, and advanced clinical stage were associated with worse OS in patients treated with chemotherapy with and without rituximab. EBV-positive DLBCL of the elderly is a clinically aggressive entity with a short OS and typically presents with advanced stage, high IPI score, and a NGC phenotype. Further studies are needed to investigate if rituximab-containing regimens are associated with better response and OS rates in EBV-positive DLBCL of the elderly.
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MESH Headings
- Age Factors
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/therapeutic use
- Doxorubicin/administration & dosage
- Doxorubicin/therapeutic use
- Female
- Herpesvirus 4, Human/isolation & purification
- Humans
- Lymphocyte Count
- Lymphoma, Large B-Cell, Diffuse/blood
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Neoplasm Staging
- Peru
- Prednisone/administration & dosage
- Prednisone/therapeutic use
- Remission Induction
- Retrospective Studies
- Rituximab
- Sex Distribution
- Survival Analysis
- Vincristine/administration & dosage
- Vincristine/therapeutic use
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68
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Ernesto Beltrán B, Quiñones Avila P, Morales Luna D, Cotrina Montenegro E, Gallo López A, López Ilasaca M. [Gastrointestinal Epstein Barr virus positive diffuse large B cell lymphoma in elderly: report of five cases and review of literature]. REVISTA DE GASTROENTEROLOGIA DEL PERU : ORGANO OFICIAL DE LA SOCIEDAD DE GASTROENTEROLOGIA DEL PERU 2011; 31:285-288. [PMID: 22086324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
EBV-positive diffuse large B-cell lymphoma (DLBCL) in elderly is a new entity included provisionally in the most recent WHO Classification of lymphoid neoplasms. It usually affects elderly patients and has a poor survival. The goal of this report was to evaluate clinical, endoscopic characteristics and survival of five patients with this entity and gastrointestinal afectation. From five cases, three cases had gastric infiltration, one ileon and one in cecum.
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69
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Chen XQ, Peng JW, Lin GN, Li M, Xia ZJ. The effect of prophylactic lamivudine on hepatitis B virus reactivation in HBsAg-positive patients with diffuse large B-cell lymphoma undergoing prolonged rituximab therapy. Med Oncol 2011; 29:1237-41. [PMID: 21556931 DOI: 10.1007/s12032-011-9974-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 04/29/2011] [Indexed: 12/19/2022]
Abstract
The association of prolonged rituximab therapy and hepatitis B virus (HBV) reactivation in diffuse large B-cell lymphoma (DLBCL) and the role of lamivudine prophylaxis remain undefined. The prevalence and mortality of HBV reactivation in HBsAg-positive patients with DLBCL undergoing rituximab-based treatment, who received prophylactic treatment with or without lamivudine, were retrospectively analyzed. From January 2003 to December 2009, there were 50 patients enrolled in the study, among of which 30 received the prophylactic treatment of lamivudine and 20 without prophylactic treatment of lamivudine. Among of the 50 patients, seven patients received further rituximab maintenance, once every 3 months for 2 years. Compared with lamivudine treatment group, it showed that there was significantly higher prevalence of HBV reactivation (60.0% vs 13.3%, P = .001), severe hepatitis (45.0% vs 6.7%, P = .004), and mortality (25.0% vs 3.3%, P = .032) in non-lamivudine prophylactic group; however, there was no statistically significant difference in the HBV DNA levels at reactivation (3.94 × 10(6) vs 8.30 × 10(5) copies/ml, P = .47) and the time from first dose of rituximab to HBV reactivation(207 vs 386 days, P = .28). For patients undergoing further rituximab maintanence treatment, the prevalence and mortality of HBV reactivation were 71.4 and 28.6%, respectively. The prevalence and mortality of HBV reactivation are 66.7% vs 75.0% (P = 1.00) and 0 vs 50.0% (P = .43) in lamivudine prophylactic and non-lamivudine prophylactic groups, respectively. The effect of lamivudine prophylaxis on preventing HBV reactivation was found to be less in patients undergoing longer duration of rituximab treatment. A longer duration of rituximab treatment contributed to higher morbidity and mortality of HBV reactivation in HbsAg-positive patients with DLBCL. Further study is warranted for the optimal management of hepatitis caused by HBV reactivation.
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Nakayama-Ichiyama S, Yokote T, Iwaki K, Miyoshi T, Takubo T, Tsuji M, Hanafusa T. Co-infection of human herpesvirus-6 and human herpesvirus-8 in primary cutaneous diffuse large B-cell lymphoma, leg type. Br J Haematol 2011; 155:514-6. [PMID: 21517824 DOI: 10.1111/j.1365-2141.2011.08702.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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71
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Castillo JJ, Beltran BE, Miranda RN, Paydas S, Winer ES, Butera JN. Epstein-barr virus-positive diffuse large B-cell lymphoma of the elderly: what we know so far. Oncologist 2011; 16:87-96. [PMID: 21212426 DOI: 10.1634/theoncologist.2010-0213] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Epstein-Barr virus-positive (EBV-positive) diffuse large B-cell lymphoma (DLBCL) of the elderly is a newly described lymphoproliferative disorder recently included as a "provisional" entity in the most current WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. The objective of this review is to provide a thorough and current summary of the existing knowledge of this subtype of DLBCL. We will review and discuss the incidence of EBV expression in DLBCL, the pathogenesis behind EBV-driven malignant transformation of B cells, the different EBV latency patterns associated with DLBCL, the distinct pathologic characteristics of EBV-positive DLBCL, the potential predictive and prognostic value of EBV tumoral status in patients with DLBCL, and potential strategies for the treatment of this rare entity, which is characterized by a suboptimal response to therapy and poor survival rate.
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Cordes C, Tiemann M, Tiemann K, Knappe D, Hoffmann M, Gottschlich S. Epstein-Barr virus-associated diffuse large B-cell lymphoma of the hypopharynx. B-ENT 2011; 7:43-46. [PMID: 21563556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
PROBLEMS/OBJECTIVES Epstein-Barr virus (EBV) is commonly associated with nasopharyngeal carcinoma and Burkitt's lymphoma, but association with hypopharyngeal and laryngeal tumours is rare. To the best of our knowledge, this is the first case report of an EBV-associated diffuse large B-cell lymphoma (DLBCL) of the hypopharynx. METHODOLOGY A 63-year-old male patient suffering from chronic lymphocytic leukemia presented with swallowing disorders and a sore throat. Panendoscopy with laser surgical resection of tissue specimens was performed. RESULTS Immunohistochemical and molecular genetic diagnostics, including EBV-encoded small RNA in situ hybridization, confirmed the diagnosis of an EBV-associated DLBCL of the hypopharynx. Ten weeks after the diagnosis, the patient died of disease related to multiple complications. CONCLUSIONS We hypothesize that the EBV infection was triggered by long-term immunosuppressive therapy that led secondarily to the development of a DLBCL. Otorhinolaryngologists should keep in mind that lymphomas might develop in the entire pharynx.
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MESH Headings
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/epidemiology
- Fatal Outcome
- Humans
- Hypopharyngeal Neoplasms/diagnostic imaging
- Hypopharyngeal Neoplasms/epidemiology
- Hypopharyngeal Neoplasms/virology
- Immunocompromised Host
- Immunohistochemistry
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/epidemiology
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/epidemiology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Pyriform Sinus/virology
- Tomography, X-Ray Computed
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Nimubona S, Bernard M, De Guibert S, Duval H, Caulet-Maugendre S, Tass P, Lamy T. Age-related Epstein-Barr virus-associated B-cell lymphoproliferative disorders in elderly white patients. Histopathology 2010; 57:320-3. [PMID: 20716175 DOI: 10.1111/j.1365-2559.2010.03605.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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74
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Huang YH, Wu QL, Zong YS, Kuang YL, Lu JB. [Nasopharyngeal EBV-positive diffuse large B-cell lymphoma occurring in elderly: report of a case]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2010; 39:634. [PMID: 21092596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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75
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StatBite: Lymphoma incidence in HIV patients vs. general population. J Natl Cancer Inst 2010; 102:1003. [PMID: 20616355 DOI: 10.1093/jnci/djq268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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