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Hayashino K, Yoshida C, Ayata Y, Yukawa R, Komura A, Nakamura M, Meguri Y, Yamamoto K, Oda W, Imajo K. Extranodal natural killer/T-cell lymphoma coexisting with peripheral T-cell lymphoma, not otherwise specified. J Clin Exp Hematop 2024; 64:52-58. [PMID: 38538319 PMCID: PMC11079987 DOI: 10.3960/jslrt.23049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 05/12/2024] Open
Abstract
We report the case of a 52-year-old male who presented to our hospital with cervical lymphadenopathy. Lymph node biopsy revealed small atypical lymphoid cells positive for CD3 and CD5 and negative for CD56 and Epstein-Barr virus (EBV)-encoded small RNA (EBER) by in situ hybridization. CD4-positive cells and CD8-positive cells were mixed in almost equal numbers. He was diagnosed with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). The patient received one cycle of chemotherapy, resulting in severe sepsis. While undergoing treatment in the intensive care unit with an antimicrobial agent and prednisone, ascitic fluid appeared. Abdominal aspiration revealed neutrophil-predominant ascites and microbiological studies revealed Candida albicans. However, ascites did not improve when treated with micafungin for Candida peritonitis. Abdominal aspiration was re-performed, and atypical lymphoid cells that were positive for CD3 and CD56 were detected. EBV-DNA levels in whole blood were significantly elevated. Atypical lymphoid cells were positive for EBER by in situ hybridization and Southern blot analysis showed EBV terminal repeat monoclonal patterns. Bone marrow examination revealed the same atypical lymphoid cells. Therefore, the patient was diagnosed with extranodal natural killer/T-cell lymphoma (ENKTL) with bone marrow involvement 3 months after the diagnosis of PTCL-NOS. Complications associated with PTCL-NOS and ENKTL are rare. PTCL-NOS, chemotherapy, sepsis, and prednisone might have led to immunodeficiency and reactivation of EBV, which might be one of the pathophysiologies for developing ENKTL. Our case indicates that measuring EBV-DNA in the blood is a simple and prompt examination to detect complications of EBV-associated lymphoma.
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MESH Headings
- Male
- Humans
- Middle Aged
- Epstein-Barr Virus Infections/complications
- Herpesvirus 4, Human
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/drug therapy
- Prednisone
- Lymphoma, Extranodal NK-T-Cell/complications
- Lymphoma, Extranodal NK-T-Cell/diagnosis
- Ascites/complications
- Ascites/pathology
- Killer Cells, Natural/pathology
- DNA
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Kimura S, Oshiro Y, Iwasaki H, Kadowaki M, Ogata M, Daa T, Sakata T, Kawauchi S, Wang Z, Takamatsu Y, Takeshita M. Clinicopathological findings, prognosis, and Epstein-Barr virus infection in rheumatoid arthritis patients with other iatrogenic immunodeficiency-associated T- and NK-cell lymphoproliferative disorders. BMC Cancer 2022; 22:1342. [PMID: 36544095 PMCID: PMC9773610 DOI: 10.1186/s12885-022-10358-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Other iatrogenic immunodeficiency-associated (OIIA) T- and natural killer (NK)-cell lymphoproliferative disorders (TNK-LPDs) are rare in patients with rheumatoid arthritis (RA). METHODS We investigated the clinicopathological characteristics, Epstein-Barr virus (EBV) infection, genetic findings, therapeutic response, and prognostic factors in 21 RA patients with OIIA TNK-LPDs and compared these with those of 39 with OIIA B-cell LPDs (B-LPDs) and 22 with non-OIIA B-LPDs. RESULTS Immunohistologically, 11 patients (52%) showed CD4+ T-LPDs, and 7 had a T follicular helper (TFH) phenotype. The other nine patients (43%) showed CD8+ T-LPDs, and the remaining one (5%) had features of CD3+ CD4- CD8- nasal type TNK-cell lymphoma. CD30+, p53+, and CMYC+ atypical lymphocytes were identified in seven (33%), eight (38%), and five (24%) patients, respectively. In situ hybridisation detected EBV-encoded RNA (EBER) + large atypical lymphocytes in five patients (24%). Nine of 17 patients (53%) showed clonal peaks of TCRγ by polymerase chain reaction. Withdrawal of MTX and biologic drugs was effective in 12 patients (57%), and 8 (38%) received chemotherapies. Two patients with TFH+ or EBV+ CD4+ CD30+ large cell peripheral T-cell lymphoma, one with CD8+ systemic anaplastic large cell lymphoma, and two with systemic EBV+ CD8+ T-cell lymphoma of childhood showed a lethal progressive clinical course within 13 months. Moreover, > 500 U/L LDH, large atypical lymphocytes, expression of CD30, p53, and CMYC, and EBER+ atypical lymphocytes were significantly poor prognostic factors for overall survival (p < 0.05). Median interval from RA onset to OIIA TNK-LPDs was 72 months, which was shorter than 166 months in OIIA B-LPDs (p = 0.003). EBV+ atypical and reactive lymphocytes were frequently found in 15 patients with OIIA TNK-LPDs (71%), in 27 with OIIA B-LPDs (69%), and only in 3 with non-OIIA B-LPDs (14%). CONCLUSIONS OIIA TNK-LPDs occurred in early phase of RA, compared with OIIA B-LPDs, and occasionally showed a lethal progressive clinical course. Detection of OIIA TNK-LPD patients with poor prognostic factors is necessary. EBV infection in immunosuppressed patients due to persistent RA, MTX, and biologic drugs may play a role in forming the tumour microenvironment and lymphomagenesis of TNK-LPDs.
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Affiliation(s)
- Shoichi Kimura
- grid.411497.e0000 0001 0672 2176Graduate School of Medical Sciences, Division of Pathomorphology, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan ,grid.411497.e0000 0001 0672 2176Department of Pathology, Faculty of Medicine, and Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan
| | - Yumi Oshiro
- grid.416592.d0000 0004 1772 6975Department of Pathology, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, 7910000 Japan
| | - Hiromi Iwasaki
- grid.470350.50000 0004 1774 2334Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563 Japan
| | - Masanori Kadowaki
- grid.470350.50000 0004 1774 2334Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563 Japan
| | - Masao Ogata
- grid.412334.30000 0001 0665 3553Department of Hematology, Faculty of Medicine, Oita University, Idaigaoka, Hazama-machi, Yufushi, Oita, 8795593 Japan
| | - Tsutomu Daa
- grid.412334.30000 0001 0665 3553Department of Pathology, Faculty of Medicine, Oita University, Idaigaoka, Hazama-machi, Yufushi, Oita, 8795593 Japan
| | - Toshifumi Sakata
- grid.411497.e0000 0001 0672 2176Department of Otolaryngology, Faculty of Medicine, and Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan
| | - Shigeto Kawauchi
- Department of Pathology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563 Japan
| | - Ziyao Wang
- grid.411497.e0000 0001 0672 2176Graduate School of Medical Sciences, Division of Pathomorphology, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan ,grid.411497.e0000 0001 0672 2176Department of Pathology, Faculty of Medicine, and Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan
| | - Yasushi Takamatsu
- grid.411497.e0000 0001 0672 2176Department of Internal Medicine, Division of Medical Oncology, Hematology and Infectious Disease, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan
| | - Morishige Takeshita
- grid.411497.e0000 0001 0672 2176Graduate School of Medical Sciences, Division of Pathomorphology, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan ,grid.411497.e0000 0001 0672 2176Department of Pathology, Faculty of Medicine, and Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180 Japan
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Kakiuchi S, Yakushijin K, Takagi I, Rikitake J, Akiyama H, Matsuba H, Hayashi Y, Kajimoto K, Iwata N. Case Report: Composite Angioimmunoblastic T-Cell Lymphoma and Epstein-Barr Virus-Positive B-Cell Lymphoproliferative Disorder as Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders. Front Med (Lausanne) 2020; 7:625442. [PMID: 33425968 PMCID: PMC7785868 DOI: 10.3389/fmed.2020.625442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2020] [Indexed: 12/02/2022] Open
Abstract
Immunosuppressants are widely used to treat patients with rheumatoid arthritis (RA), and their adverse effects have been known to cause other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs). We report a patient with RA who had been treated with methotrexate (MTX) and tacrolimus (TAC) and who developed whole body lymphadenopathy. We simultaneously confirmed angioimmunoblastic T-cell lymphoma (AITL) through a right cervical lymph node biopsy and Epstein-Barr virus-positive B-cell lymphoproliferative disorder (EBV-positive B-LPD) through a bone marrow examination. After cessation of immunosuppressant therapy, both LPDs completely disappeared. Patients with AITL are occasionally reported to develop B-cell lymphoma through reactivation of the EBV, which leads to clonal expansion in the microenvironment. Immunohistochemistry results revealed that both LPD components were positive for EBV-encoded RNA. Moreover, in this patient, the plasma EBV DNA level was found to be high; therefore, EBV infection was a probable etiology. Synchronous coexistence of AITL and B-LPD as an OIIA-LPD has rarely been reported. This case report is the first to discuss the disappearance of both LPDs on withdrawal of immunosuppressants only. AITL occasionally accompany B-LPD; however, this composite lymphoma comprised AITL and B-LPD, and OIIA-LPDs should not be overlooked.
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Affiliation(s)
- Seiji Kakiuchi
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan.,Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikumi Takagi
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Junpei Rikitake
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan.,Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Akiyama
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroyuki Matsuba
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Yoshitake Hayashi
- Division of Molecular Medicine & Medical Genetics, Department of Pathology, Kobe Graduate School of Medicine, Kobe, Japan
| | | | - Nobuko Iwata
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
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Tachibana T, Sasaki T, Wani Y, Komatsubara Y, Kuroda K, Naoi Y, Gion Y, Orita Y, Nishizaki K, Sato Y. Methotrexate-Associated Lymphoproliferative Disorders Mimicking Granulomatosis With Polyangiitis: A Radiological Diagnostic Challenge. EAR, NOSE & THROAT JOURNAL 2020; 101:NP362-NP366. [PMID: 33155857 DOI: 10.1177/0145561320970685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Methotrexate-associated lymphoproliferative disorders (MTX-LPD) frequently involve the extranodal organs throughout the body. Among the extranodal occurrences of MTX-LPD, pulmonary involvement is most frequent. In contrast, there are only a few reports of MTX-LPD in the nasal cavity or paranasal sinuses. Moreover, there are no previous reports of MTX-LPD mimicking granulomatosis with polyangiitis (GPA) in imaging examinations. We describe a case of a 53-year-old woman with MTX-LPD mimicking GPA in the nasal cavity and lungs. She complained of left nasal obstruction and discharge, general fatigue, and continual fever for 2 months. The patient had been diagnosed with rheumatoid arthritis and received methotrexate (MTX) for over 10 years. Contrast-enhanced computed tomography revealed unenhanced masses in the nasal cavity and multiple masses with cavitary changes in the bilateral lungs, suggesting GPA. However, histological examination of the nasal lesion and a history of MTX treatment indicated a diffuse large B-cell lymphoma type MTX-LPD. Two weeks after MTX withdrawal, prominent improvements in both lesions were observed. Complete regression of the nasal lesion was observed 3 months after discontinuation of MTX. Thus, MTX-LPD may mimic GPA in imaging examinations.
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Affiliation(s)
- Tomoyasu Tachibana
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Tomoaki Sasaki
- Department of Radiological Technology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Yoji Wani
- Department of Pathology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yasutoshi Komatsubara
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Kazunori Kuroda
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yuto Naoi
- Department of Otolaryngology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Yuka Gion
- Department of Clinical Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yorihisa Orita
- Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Sato
- Department of Clinical Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Tokuhira M, Tamaru JI, Kizaki M. Clinical management for other iatrogenic immunodeficiency-associated lymphoproliferative disorders. J Clin Exp Hematop 2019; 59:72-92. [PMID: 31257348 PMCID: PMC6661962 DOI: 10.3960/jslrt.19007] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD), a category of immunodeficiency-associated LPD according to the World Health Organization classification, is associated with immunosuppressive drugs (ISDs). Several factors, including autoimmune disease (AID) activity, Epstein-Barr virus (EBV) infection, ISD usage, and aging, influence the development of OIIA-LPD, resulting in complicated clinical courses and outcomes. Most OIIA-LPD develops in patients with rheumatoid arthritis using methotrexate (MTX-LPD). The management of MTX-LPD is based on the clinical course, i.e., with/without regression, with/without relapse/regrowth event (RRE), LPD subtype, and ISDs for AIDs after LPD development. There are three clinical courses after ISD withdrawal: regressive LPD without relapse/regrowth (R-G), regressive LPD with RRE (R/R-G), and persistent LPD (P-G). The majority of EBV+ diffuse large B-cell lymphomas are classified in R-G, whereas classic Hodgkin lymphoma is generally classified in R/R-G. Polymorphic LPD (P-LPD) in MTX-LPD develops with heterogeneous pathological features similar to monomorphic LPD. Chemotherapy for MTX-LPD is selected according to that for de novo LPD, although the strategy for aggressive P-LPD and non-specific LPD is not well established. The absolute lymphocyte count in the peripheral blood has been suggested as a candidate marker for MTX-LPD development and RRE. Several clinical issues, including correct diagnosis among overlapping clinicopathological features in MTX-LPD and clinical management of LPD by ISDs other than MTX, require further investigation.
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6
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Satou A, Tsuzuki T, Nakamura S. Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders with a T- or NK-cell phenotype. J Clin Exp Hematop 2019; 59:56-63. [PMID: 31257346 PMCID: PMC6661958 DOI: 10.3960/jslrt.19013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs) with a T- or NK-cell phenotype are markedly rare, with only a limited number of cases having been reported thus far. Methotrexate (MTX) is the most common agent used for OIIA-LPD patients, and 43 cases of MTX-associated T-LPDs (MTX T-LPDs) and five cases of MTX-associated NK/T-LPDs (MTX NK-LPDs) have been described. In addition to MTX T-LPDs and MTX NK/T-LPDs, T-LPD and NK/T-LPDs have been reported in patients receiving other immunosuppressive agents such as thiopurines, TNF antagonists, and cyclosporine. Hepatosplenic T-cell lymphoma (HSTL) is specifically associated with iatrogenic immunodeficiency, and 10% of HSTL cases develop in patients receiving thiopurines and/or TNF antagonists for inflammatory bowel disease (IBD). In this review, we focused on MTX T-LPD, MTX NK/T-LPD, and HSTL in patients with IBD. These T- and NK/T-cell associated OIIA-LPDs are the most common in daily medical practice.
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Shimizu Y, Nakajima A, Inoue E, Shidara K, Sugimoto N, Seto Y, Tanaka E, Momohara S, Taniguchi A, Yamanaka H. Characteristics and risk factors of lymphoproliferative disorders among patients with rheumatoid arthritis concurrently treated with methotrexate: a nested case-control study of the IORRA cohort. Clin Rheumatol 2017; 36:1237-1245. [DOI: 10.1007/s10067-017-3634-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/04/2017] [Accepted: 04/11/2017] [Indexed: 12/17/2022]
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8
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Prognostic factors of methotrexate-associated lymphoproliferative disorders associated with rheumatoid arthritis and plausible application of biological agents. Mod Rheumatol 2016; 27:773-777. [DOI: 10.1080/14397595.2016.1259714] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Tajima S, Takanashi Y, Koda K, Fukayama M. Methotrexate-associated lymphoproliferative disorder presenting as extranodal NK/T-cell lymphoma arising in the lungs. Pathol Int 2015; 65:661-5. [PMID: 26459854 DOI: 10.1111/pin.12346] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/04/2015] [Indexed: 11/30/2022]
Abstract
Patients having rheumatoid arthritis (RA) treated with methotrexate (MTX) are at an increased risk of developing lymphoproliferative disorder (LPD). Epstein-Barr virus (EBV) sometimes contributes to the development of MTX-associated LPD. Herein, we report the case of a 64-year-old Japanese woman with RA who showed complications of EBV-positive MTX-associated LPD. This case is exceedingly rare in that the LPD was confined to the lungs and its subclassification was extranodal NK/T-cell lymphoma. Only four cases of extranodal NK/T-cell lymphoma in the setting of MTX-associated LPD have ever been reported in the English language literature, only one of which was an extranasal NK/T-cell lymphoma, similar to our case. Extranasal NK/T-cell lymphomas show more aggressive behavior than nasal NK/T-cell lymphomas, possibly reflected by the considerable re-exacerbation of the lesions in only two months after the cessation of MTX in our case. However, the SMILE regimen (steroid, methotrexate, ifosfamide, l-asparaginase, and etoposide) was able to suppress tumor growth in this case.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yusuke Takanashi
- Department of Chest Surgery, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - Kenji Koda
- Department of Pathology, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Gandhi J, Gaur N, Khera L, Kaul R, Robertson ES. COX-2 induces lytic reactivation of EBV through PGE2 by modulating the EP receptor signaling pathway. Virology 2015; 484:1-14. [PMID: 26057147 PMCID: PMC4567511 DOI: 10.1016/j.virol.2015.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/28/2015] [Accepted: 05/11/2015] [Indexed: 01/12/2023]
Abstract
Inflammation is one of the predisposing factors known to be associated with Epstein Barr Virus (EBV) mediated tumorigenesis. However it is not well understood whether inflammation in itself plays a role in regulating the life cycle of this infectious agent. COX-2, a key mediator of the inflammatory processes is frequently over-expressed in EBV positive cancer cells. In various tumors, PGE2 is the principle COX-2 regulated downstream product which exerts its effects on cellular processes through the EP1-4 receptors. In this study, we further elucidated how upregulated COX-2 levels can modulate the events in EBV life cycle related to latency-lytic reactivation. Our data suggest a role for upregulated COX-2 on modulation of EBV latency through its downstream effector PGE2. This study demonstrates a role for increased COX-2 levels in modulation of EBV latency. This is important for understanding the pathogenesis of EBV-associated cancers in people with chronic inflammatory conditions.
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Affiliation(s)
- Jaya Gandhi
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Nivedita Gaur
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Lohit Khera
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Rajeev Kaul
- Department of Microbiology, University of Delhi South Campus, New Delhi, India.
| | - Erle S Robertson
- Department of Microbiology and Tumour Virology Program, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.
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Yamada K, Oshiro Y, Okamura S, Fujisaki T, Kondo S, Nakayama Y, Suematsu E, Tamura K, Takeshita M. Clinicopathological characteristics and rituximab addition to cytotoxic therapies in patients with rheumatoid arthritis and methotrexate-associated large B lymphoproliferative disorders. Histopathology 2015; 67:70-80. [DOI: 10.1111/his.12627] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/24/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Kozue Yamada
- Department of Pathology; Faculty of Medicine; Fukuoka University; Fukuoka Japan
| | - Yumi Oshiro
- Department of Pathology; Matsuyama Red Cross Hospital; Matsuyama Japan
| | - Seiichi Okamura
- Department of Internal Medicine; Clinical Research Center; National Hospital Organization Kyushu Medical Center; Fukuoka Japan
| | - Tomoaki Fujisaki
- Department of Hematology; Matsuyama Red Cross Hospital; Matsuyama Japan
| | - Seiji Kondo
- Department of Internal Medicine; Clinical Research Center; National Hospital Organization Kyushu Medical Center; Fukuoka Japan
| | - Yoshifuku Nakayama
- Department of Pathology; Clinical Research Center; National Hospital Organization Kyushu Medical Center; Fukuoka Japan
| | - Eiichi Suematsu
- Department of Internal Medicine; Clinical Research Center; National Hospital Organization Kyushu Medical Center; Fukuoka Japan
| | - Kazuo Tamura
- Division of Medical Oncology, Hematology and Infectious Disease; Department of Internal Medicine; Faculty of Medicine; Fukuoka University; Fukuoka Japan
| | - Morishige Takeshita
- Department of Pathology; Faculty of Medicine; Fukuoka University; Fukuoka Japan
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Hematologic malignancies in the Japanese patients with inflammatory bowel disease. J Gastroenterol 2014; 49:1299-306. [PMID: 23955181 DOI: 10.1007/s00535-013-0873-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 08/07/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although attention has been focused for over 20 years on the possible increased risk for hematologic malignancies (HM) in patients with inflammatory bowel diseases (IBD) receiving immune-modulators or anti-TNF-alpha antibodies, the association is still controversial. To understand the actual conditions of HM in the Japanese patients with IBD, the research committee for IBD supported by the Ministry of Health, Welfare and Labor of Japan (IBD-MHWL) conducted a multi-center retrospective study. METHODS Questionnaires for the development of HM in IBD patients were sent to the 70 facilities participating with IBD-MHWL in the first survey, followed by the second survey using a more detailed questionnaire, sent to the 27 members with HM patients. RESULTS Out of a total of 36,939 IBD patients in 70 facilities, 28 cases of HM related with IBD [12 of 10,500 UC patients (0.11 %), 16 of 6,310 CD patients (0.25 %)] were analyzed. The numbers of UC patients who developed HM were 2 (0.15 %) from the group receiving and 10 (0.13 %) from the group non-receiving thiopurine, without significant differences. The numbers of CD patients who developed HM were 4 (0.39 %) from the group receiving and 12 (0.21 %) from the group non-receiving thiopurine, without significant differences. The odds ratios of developing HM by thiopurine were 1.37 (95 % CI 0.30-6.24) in UC patients and 1.86 (95 % CI 0.60-5.78) in CD patients. CONCLUSIONS Our results suggested that thiopurine therapy may not be a risk factor for HM in Japanese patients with IBD. Further accumulation of cases and prospective studies are necessary to conclude this important issue.
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Increased expression of Trop2 correlates with poor survival in extranodal NK/T cell lymphoma, nasal type. Virchows Arch 2013; 463:713-9. [PMID: 23979406 DOI: 10.1007/s00428-013-1475-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Revised: 07/15/2013] [Accepted: 08/13/2013] [Indexed: 12/28/2022]
Abstract
Human trophoblastic cell surface antigen 2 (Trop2) has been suggested to play an important role in the development of solid tumors. However, the expression of Trop2 in extranodal NK/T cell lymphoma, nasal type (ENKTL) and the relationship with the clinical characteristics of this disease remain poorly understood. In this study, one-step quantitative PCR reverse transcription-polymerase chain reaction and immunohistochemical staining with tissue sections were employed to evaluate the expression of Trop2 in ENKTL. Furthermore, the relationship between Trop2 expression and prognosis of ENKTL was investigated. Expression of Trop2 mRNA and protein was significantly higher in ENKTL tissue than in corresponding non-lymphomatous tissue (p = 0.04 and p < 0.001, respectively). Expression of Trop2 protein in ENKTL was associated with lymph node involvement and poor overall survival (p = 0.045 and p = 0.018, respectively). Kaplan-Meier analysis and the logrank test indicated that lymph node involvement (p = 0.0481), single therapy strategy (p = 0.0037), and high expression of Trop2 (p = 0.0042) are significantly correlated with poor prognosis of ENKTL patients. The data suggest that Trop2 expression reflects a more malignant phenotype and may serve as an unfavorable prognostic factor for ENKTL.
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