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Haverkos BM, Gru AA, Geyer SM, Bingman AK, Hemminger JA, Mishra A, Wong HK, Pancholi P, Freud AG, Caligiuri MA, Baiocchi RA, Porcu P. Increased Levels of Plasma Epstein Barr Virus DNA Identify a Poor-Risk Subset of Patients With Advanced Stage Cutaneous T-Cell Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 16 Suppl:S181-S190.e4. [PMID: 27521316 DOI: 10.1016/j.clml.2016.02.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 02/09/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Outcomes in advanced stage (AS) cutaneous T-cell lymphomas (CTCL) are poor but with great variability. Epstein-Barr virus (EBV) is associated with a subset of non-Hodgkin lymphomas. Frequency of plasma EBV-DNA (pEBVd) detection, concordance with EBV RNA (EBER) in tumor tissue, codetection of plasma cytomegalovirus DNA (pCMVd), and prognostic effect in AS CTCL are unknown. PATIENTS AND METHODS Patients (n = 46; 2006-2013) with AS CTCL (≥IIB) were retrospectively studied. pEBVd and pCMVd were longitudinally measured using quantitative real-time polymerase chain reaction. EBER in situ hybridization (ISH) was performed on tumor samples. Survival from time of diagnosis (ToD) and time of progression to AS was assessed. RESULTS Plasma EBV-DNA and pCMVd were detected in 37% (17 of 46) and 17% (8 of 46) of AS CTCL patients, respectively. pCMVd detection was significantly more frequent in pEBVd-positive (pEBVd(+)) than pEBVd(-) patients (35% vs. 7%; P = .038). Tumor tissue for EBER-ISH was available in 14 of 17 pEBVd(+) and 22 of 29 pEBVd(-) patients; 12 of 14 (85.7%) pEBVd(+) patients were EBER(+) versus 0 of 22 pEBVd(-) patients. Frequency of large cell transformation (LCT) tended to be greater in pEBVd(+) patients, but was not significant (10 of 14 pEBVd(+) vs. 10 of 23 pEBVd(-); P = .17). No notable differences in rates of increased levels of serum lactate dehydrogenase (LDH) were observed (17 of 17 pEBVd(+) vs. 27 of 29 pEBVd(-)). pEBVd detection was associated with significantly worse survival from ToD (P = .021) and time of progression to AS (P = .0098). CONCLUSION Detection of cell-free plasma EBV-DNA was highly concordant with the presence of EBERs in tumor tissue, predicted survival independent of LDH and LCT, and should be further studied as a biomarker in AS CTCL.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers
- Biopsy
- DNA, Viral
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/virology
- Female
- Follow-Up Studies
- Herpesvirus 4, Human/genetics
- Humans
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/etiology
- Lymphoma, T-Cell, Cutaneous/mortality
- Lymphoma, T-Cell, Cutaneous/therapy
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Retrospective Studies
- Skin/pathology
- Survival Analysis
- Treatment Outcome
- Viral Load
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Affiliation(s)
| | - Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, VA
| | - Susan M Geyer
- Department of Pediatrics Health Informatics Institute, University of South Florida, Tampa, FL
| | - Anissa K Bingman
- Center for Biostatistics, The Ohio State University, Columbus, OH
| | | | - Anjali Mishra
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Dermatology, The Ohio State University, Columbus, OH
| | - Henry K Wong
- Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, AR
| | - Preeti Pancholi
- Department of Pathology, The Ohio State University, Columbus, OH
| | - Aharon G Freud
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH
| | - Michael A Caligiuri
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH
| | - Robert A Baiocchi
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH
| | - Pierluigi Porcu
- The Comprehensive Cancer Center and The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH; Division of Hematology, The Ohio State University, Columbus, OH.
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Messana K, Marburger T, Bergfeld W. EBV-Negative Cutaneous Lymphomatoid Granulomatosis With Concomitant EBV-Positive Pulmonary Involvement. Am J Dermatopathol 2015; 37:707-11. [DOI: 10.1097/dad.0000000000000198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Nahidi Y, Meibodi NT, Ghazvini K, Esmaily H, Hesamifard M. Evaluation of the Association Between Epstein-Barr Virus and Mycosis Fungoides. Indian J Dermatol 2015; 60:321. [PMID: 26120176 PMCID: PMC4458961 DOI: 10.4103/0019-5154.156423] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mycosis fungoides (MF) is the most common cutaneous T-cell lymphomas. Despite extensive studies, etiopathogenesis of MF is unknown. Environmental, infectious and genetic factors have been proposed as potential risk factors of MF. Herpes virus family members, especially Epstein-Barr virus (EBV), have been among the viral factors of interest in recent years. The aim of this study was to investigate the possible association of EBV infection with MF. MATERIALS AND METHODS This case-control study was performed on skin biopsy samples of 57 MF patients referred to Pathology Department of Mashhad Emam Reza Hospital from 2000 to 2011 and also on 57 melanocytic nevus samples matched with patients for age and sex. The presence of EBV in samples was evaluated by polymerase chain reaction. Statistical analysis of the data was conducted with the Statistical Package for the Social Sciences version 11.5 (SPSS Inc., Chicago, IL, USA). RESULTS In this study, out of 57 MF samples, there were 34 male and 23 female patients, with male:female ratio of 1.04. Mean patient age was 51.4 years. There were 22 and 4 positive cases of EBV in the case and control groups, respectively. Chi-square statistical test showed that EBV was significantly higher in case group than control (P = 0.000). There was no correlation between the presence of EBV in samples with lesion type, age and gender of the patients. CONCLUSION According to our study results, EBV is a likely etiologic agent or potential promoter in the pathogenesis of MF.
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Affiliation(s)
- Yalda Nahidi
- From the Department of Dermatology, Cutaneous Leishmanaisis Research Center, Mashhad, Iran
| | - Naser Tayyebi Meibodi
- Department of Pathology, Cutaneous Leishmanaisis Research Center, Mashhad, Iran
- Address for correspondence: Dr. Naser Tayyebi Meibodi, Cutaneous Leishmanaisis Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail:
| | - Kiarash Ghazvini
- Department of Microbiology, Research Center for Microbiology and Virilogy, Imam Reza Hospital, Faculty of Medicine, Mashhad, Iran
| | - Habiballah Esmaily
- Department of Biostatistics and epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mitra Hesamifard
- Department of Emergency Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
The etiology of cutaneous T-cell lymphoma (CTCL) remains unknown, with potential infectious causes having been explored. This contribution evaluates the evidence suggesting an infectious etiology and pathogenesis of the disease, characterizes the relationships between various specific pathogens and CTCL, and discusses some of the difficulties in establishing a causal link between infectious agents and CTCL carcinogenesis. Researchers have evaluated CTCL specimens for evidence of infection with a variety of agents, including human T-lymphotropic virus, Epstein-Barr virus, human herpesvirus-8, and Staphylococcus aureus, although other pathogens also have been detected in CTCL. Although there is significant evidence implicating one or more infectious agents in CTCL, studies to date have not linked definitively any pathogen to disease development, and various studies have yielded conflicting results.
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Epstein-Barr virus in cutaneous T-cell lymphomas: evaluation of the viral presence and significance in skin and peripheral blood. J Invest Dermatol 2009; 129:1556-61. [PMID: 19131945 DOI: 10.1038/jid.2008.396] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The importance of viral agents in the development of cutaneous T-cell lymphomas (CTCL) is still debated. For this purpose, we retrospectively evaluated the Epstein-Barr virus (EBV) presence in Sézary syndrome (SS), mycosis fungoides (MF), inflammatory dermatoses (ID), and healthy donors (HD) using different approaches: EBV-DNA was quantified in skin biopsies and peripheral blood using real-time PCR, EBV-encoded small RNA (EBER) transcripts were detected by in situ hybridization (ISH), and latent membrane protein1-2 antigens were detected by immunohistochemistry. Skin biopsies were EBV-DNA-positive in 8/30 (27%) SS, 7/71 (10%) MF, and 2/18 (11%) ID patients and in none of the 25 normal skin samples. Positive mRNA (EBER) signals, always confined to cerebriform T lymphocytes, were found in 5/30 SS patients (17%), whereas signals in all MF and ID patients were negative. The presence of EBV-DNA in skin and blood samples was associated with a significantly lower survival in MF/SS patients. In evaluating EBV serological status, most (>70%) SS, MF, and ID patients showed a serological reactivation demonstrated by the presence of anti-EA IgG. In conclusion, although the finding of EBV-DNA in CTCL does not prove its etiopathogenetic role and may be related instead to immunosuppression, our study demonstrates that it has prognostic relevance.
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6
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A report of Epstein-Barr virus–positive primary cutaneous natural killer–/T-cell lymphoma. J Am Acad Dermatol 2008; 59:157-61. [DOI: 10.1016/j.jaad.2008.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/08/2008] [Accepted: 03/28/2008] [Indexed: 11/19/2022]
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CHO K, KIM C, LEE D, SOHN S, KIM D, CHUNG J. An Epstein-Barr virus-associated lymphoproliferative lesion of the skin presenting as recurrent necrotic papulovesicles of the face. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1996.99812.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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MISAGO N, OHSHIMA K, AIURA S, KIKUCHI M, KOHDA H. Primary cutaneous T-cell lymphoma with an angiocentric growth pattern: association with Epstein-Barr virus. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1996.d01-1058.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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CHANG Y, LIU H, WONG C, CHOW K, CHEN K. Detection of Epstein-Barr virus in primary cutaneous amyloidosis. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1997.01824.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Intradural spinal seeding and fatal progression of a sacrococcygeal chordoma: a case report. Chin Med J (Engl) 2008. [DOI: 10.1097/00029330-200806020-00025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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11
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12
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CHO K, KIM C, YANG S, KIM B, KIM J. Angiocentric T cell lymphoma of the skin presenting as inflammatory nodules of the leg. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1997.tb02632.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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VIRBEN R, BROUSSET P, LINA C, LAMANT L. Cutaneous non-epidermotropic lymphoma associated with human immunodeficiency virus infection. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1997.tb01091.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Shimauchi T, Onoue A, Yamamoto O, Hino R, Tokura Y. Evidence for polyclonal infection of Epstein-Barr virus in a patient with primary cutaneous anaplastic large cell lymphoma. Clin Exp Dermatol 2004; 29:383-6. [PMID: 15245536 DOI: 10.1111/j.1365-2230.2004.01538.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report a case of CD30 + primary cutaneous anaplastic large cell lymphoma. The lymphoma cells were shown to express the Epstein-Barr virus (EBV)-encoded small RNAs by in situ hybridization and to have EBV genomes by PCR, whereas no monoclonal band was detected by Southern blot analysis using the EBV terminal repeat probe. These data suggested polyclonal infection by EBV, which provides evidence that EBV plays little part in the pathogenesis of this tumour even in the infected cases.
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Affiliation(s)
- T Shimauchi
- Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyusyu, Japan.
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15
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Abstract
An 8-year-old Taiwanese girl had a 6-month history of a relapsing papulovesicular eruption on her face that resembled hydroa vacciniforme (HV). Histologically, there was a dense infiltration of large atypical lymphocytic cells expressing CD8. TCR-gamma gene rearrangement study revealed a monoclonal band present in the DNA extracted from the specimen. A diagnosis of CD8+ cutaneous T-cell lymphoma (CTCL) was made. The patient was treated with Chinese herbal drugs and her skin lesions waxed and waned. At this writing, 11 months after establishment of the diagnosis, the skin lesions have been limited to the facial area and no definite evidence of systemic involvement is noted. To our knowledge, this is the first case of CD8+ primary CTCL with clinical features resembling HV.
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Affiliation(s)
- H-H Chen
- Department of Dermatology, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei, Taiwan
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16
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Abstract
The most common cutaneous manifestations of EBV include IM, OHL, and cutaneous lymphoproliferative disorders. Infectious mononucleosis is a self-limited manifestation of acute EBV infection. The transient rash that occurs quite commonly in patients with IM who have received antibiotic therapy is an erythematous, maculopapular eruption, usually located on the trunk and upper extremities. Oral hairy leukoplakia occurs in immunosuppressed HIV-positive and HIV-negative individuals. In HIV-positive individuals, it serves as an indicator of disease severity and rapid progression to AIDS. The presence of OHL in an individual should prompt the clinician to perform a through history-taking and investigation of immune status. Cutaneous lymphoproliferative disorders associated with EBV occur in individuals with congenital or acquired immunodeficiency syndromes.
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17
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Barrionuevo C, Anderson VM, Zevallos-Giampietri E, Zaharia M, Misad O, Bravo F, Cáceres H, Taxa L, Martínez MT, Wachtel A, Piris MA. Hydroa-like cutaneous T-cell lymphoma: a clinicopathologic and molecular genetic study of 16 pediatric cases from Peru. Appl Immunohistochem Mol Morphol 2002; 10:7-14. [PMID: 11893040 DOI: 10.1097/00129039-200203000-00002] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hydroa-like cutaneous T-cell lymphoma (hydroa-like CTCL) is an unusual pediatric malignancy with a poor prognosis. An impressive cutaneous rash characterized by edema, blisters, ulcers, crusts, and scars, resembling hidroa vacciniforme, is seen mainly on the face and sometimes on the extremities. The lesion consists of lymphomatous T-cell infiltration of the skin and subcutis with variable exocytosis and angiocentricity. It has been also called edematous, scarring vasculitic panniculitis and hydroa-like lymphoma. An association with Epstein-Barr virus has been suggested. The differential diagnosis includes other cutaneous lymphomas, particularly the cutaneous nasal type T/natural killer-cell lymphoma, mycosis fungoides, precursor T-cell lymphoblastic lymphoma, nonspecific peripheral T-cell lymphoma, cutaneous anaplastic large cell lymphoma, and subcutaneous panniculitic T-cell lymphoma. Other differential diagnoses are inflammatory dermatopathies and panniculitides. Based on a series of 16 such cases referred to the Institute of Neoplastic Diseases, the objective of this report is not only to provide a better clinicopathologic understanding of this entity but also a reappraisal of it as a malignancy. The male/female frequency ratio was 1:1. The median age was 10 years old. All cases showed predominant facial involvement with edema, blisters, ulcers, crusts, and scars. Chemotherapy and/or radiotherapy had little or no benefit. The prognosis was usually dismal. The lymphoma extended from the epidermis to the subcutis, with frequent angiocentric and periadnexal array. Lymphoma cells were mostly of intermediate size with dense hyperchromatic nuclei, inconspicuous nucleoli, and infrequent mitosis. A scanty and variable inflammatory background was found. The lymphoma cells displayed T-cell cytotoxic phenotype. In addition, they were negative for the natural killer cell antigens CD56 and CD57. Epstein-Barr virus in situ hybridization was positive in the six cases in which it was assayed. T-cell receptor gamma (TCRgamma) displayed monoclonal-type rearrangement in four cases studied. Our findings indicate that hydroa-like CTCL is an independent clinicopathologic entity that affects children. Consequently, it should be considered an independent subset of CTCLs and be included as such in the classification of neoplastic diseases of the lymphoid tissues.
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Affiliation(s)
- Carlos Barrionuevo
- Department of Pathology, The Institute of Neoplastic Diseases, Lima, Peru
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18
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Erkek E, Sahin S, Atakan N, Kocagöz T, Olut A, Gököz A. Examination of mycosis fungoides for the presence of Epstein-Barr virus and human herpesvirus-6 by polymerase chain reaction. J Eur Acad Dermatol Venereol 2001; 15:422-6. [PMID: 11763382 DOI: 10.1046/j.1468-3083.2001.00309.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aetiology of cutaneous T-cell lymphoma (CTCL) remains unknown despite numerous investigations. In recent years, retroviruses and human herpesviruses have been implicated to play a causal part in CTCL. OBJECTIVE The aim of this study was to elucidate the possible aetiopathogenetic role of human herpesviruses (HHV) in mycosis fungoides (MF). METHODS Polymerase chain reaction was used to study formalin-fixed, paraffin-embedded lesional skin biopsies from 92 subjects with MF to evidence possible presence of Epstein-Barr virus (EBV) and HHV-6. RESULTS Biopsy specimens from nine subjects (9.8%) evidenced EBV DNA, whereas all except one of the subjects (1.1%) lacked HHV-6 DNA. CONCLUSIONS Although these findings do not support a primary aetiological role for EBV and HHV-6 in classical CTCL, the possibility remains that both viruses, particularly EBV, may act as potential cofactors in the development of CTCL.
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Affiliation(s)
- E Erkek
- Hacettepe University, Faculty of Medicine, Ankara, Turkey.
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19
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Shimakage M, Sasagawa T, Kawahara K, Yutsudo M, Kusuoka H, Kozuka T. Expression of Epstein-Barr virus in cutaneous T-cell lymphoma including mycosis fungoides. Int J Cancer 2001; 92:226-31. [PMID: 11291050 DOI: 10.1002/1097-0215(200102)9999:9999<::aid-ijc1172>3.0.co;2-o] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cutaneous T-Cell lymphoma (CTCL) is a non-Hodgkin's lymphoma of unknown pathogenesis. Mycosis fungoides (MF) is a clinically determined subset of CTCL with intensive infiltration of lymphoma cells into the epidermis. To determine whether Epstein-Barr virus (EBV) is associated with these lymphoma cells, we performed mRNA in situ hybridization in 5 cases of CTCL and 7 cases of MF using an RNA probe transcribed from BamHI W fragment of EBV genome. These transcripts were detected in the majority of lymphoma cells in all cases examined. We also detected intensive hybridization signals on epidermal squamous cells contiguous to strong infiltration with lymphoma cells into the subcutaneous connective tissue. Similarly, positive signals were detected using the probes transcribed from the sequences of EBV-encoded small nonpolyadenylated RNAs-1 (EBER1) and EBV-determined nuclear antigen-2 (EBNA2). The EBNA2 latent membrane protein-1 (LMP1) and BZLF1 product (ZEBRA) were also detected by immunofluorescence staining using monoclonal antibodies. Further in the same experiment, we detected immunofluorescence of epidermal cells. EBV DNA was detected in all cases tested by DNA in situ hybridization. Moreover, we also identified the signals on epidermal cells via this technique. Polymerase chain reaction revealed amplified EBV DNA for most cases tested. Double staining with immunohistochemistry and RNA in situ hybridization showed that T-cell marker-positive cells, but not EBV-carrying B-cells, exhibited signals for the EB viral RNA. These findings suggest that EBV is involved in the neoplastic transformation of CTCL and MF.
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MESH Headings
- Adult
- Aged
- DNA, Viral/analysis
- Epstein-Barr Virus Nuclear Antigens/biosynthesis
- Epstein-Barr Virus Nuclear Antigens/genetics
- Epstein-Barr Virus Nuclear Antigens/immunology
- Female
- Fluorescent Antibody Technique, Indirect
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 4, Human/metabolism
- Humans
- In Situ Hybridization
- Lymphoma, T-Cell, Cutaneous/virology
- Male
- Middle Aged
- Mycosis Fungoides/virology
- RNA, Messenger/biosynthesis
- RNA, Viral/biosynthesis
- RNA, Viral/genetics
- Transcription, Genetic
- Viral Proteins
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Affiliation(s)
- M Shimakage
- Clinical Research Institute, Osaka National Hospital, 2-1-14 Hoenzaka Chuo-ku, Osaka 540-0006, Japan.
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20
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Xu ZG, Iwatsuki K, Ohtsuka M, Oyama N, Matsui T, Kaneko F. Polymorphism analysis of Epstein-Barr virus isolates from patients with cutaneous natural killer/T-cell lymphoproliferative disorders: A possible relation to the endemic occurrence of these diseases in Japan. J Med Virol 2000; 62:239-46. [PMID: 11002254 DOI: 10.1002/1096-9071(200010)62:2<239::aid-jmv16>3.0.co;2-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Certain forms of cutaneous lymphomas in Asia are associated frequently with Epstein-Barr virus (EBV) infection, whereas such cases are less common in western countries. The virus-related peptides, EBV-determined nuclear antigen (EBNA)-2 and the latent membrane protein (LMP)-1, play an essential role in cell transformation. The polymorphisms of these EBV genes may be related to their transforming abilities. In order to clarify the viral subtype that may be involved in the incidence of EBV-associated lymphomas, we analyzed the EBNA-2 and LMP-1 gene polymorphisms and mutations in healthy adults and in patients with EBV-associated cutaneous natural killer(NK)/T-cell lymphoproliferative disorders in Japan. In EBV-related cutaneous lymphoproliferative disorders, EBV subtype 1 was found in all 15 cases, and 1 sample contained a dual infection with subtypes 1 and 2. All EBV isolates from our patients lost a Xho-1 site in exon 1 of the LMP-1 gene, and 7 of 13 cases had a Nco-1 site within the promoter region. All isolates without the LMP-1-Xho-1 site had a 30 bp deletion in the carboxy terminus of the LMP-1 gene, except for the isolate from a patient with angioimmunoblastic lymphadenophathy-like T-cell lymphoma in which a novel Nco-1 site was present in exon 1. Eleven of fourteen throat washings from healthy adults which contained EBV-DNA harbored EBV subtype 1, and the EBNA2 region was not amplified in the other 3 samples. The Xho-1 site was lost in 12 (86%) of 14 isolates and the 30 bp deletion was present in 11 (78%) of 14 isolates from the throat washings. The findings indicate that the predominant EBV isolate from Japanese healthy adults and patients with cutaneous NK/T-cell lymphoproliferative disorders is subtype 1 with a 30 bp deletion and loss of a Xho-1 site in the LMP-1 gene. Since previous data indicated that either subtype 1 or the 30 bp deletion variant possesses high tumorigenic activity, the prevalence of subtype 1 containing these mutations might be responsible for the high incidence of EBV-associated lymphoproliferative disorders in Japan.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Adult
- Base Sequence
- Carrier Proteins/genetics
- Cytoskeletal Proteins
- DNA, Viral/genetics
- DNA, Viral/isolation & purification
- Endemic Diseases
- Epstein-Barr Virus Nuclear Antigens
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/isolation & purification
- Humans
- Intracellular Signaling Peptides and Proteins
- Japan/epidemiology
- LIM Domain Proteins
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/virology
- Lymphoproliferative Disorders/epidemiology
- Lymphoproliferative Disorders/virology
- Molecular Sequence Data
- Polymorphism, Genetic
- Sequence Analysis, DNA
- Viral Proteins/genetics
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Affiliation(s)
- Z G Xu
- Department of Dermatology, Fukushima Medical University School of Medicine, Fukushima, Japan
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21
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Abstract
B-cell lymphoma-associated hemophagocytic syndrome (B-LAHS) is extremely rare in Western countries but has recently been increasingly reported in Asian countries, especially Japan. Here, we reviewed 25 previously reported Japanese cases of B-LAHS and summarized its clinicopathologic features and therapeutic outcome. The median age of onset was 63 years old with initial presentation of fever, hepatomegaly, and splenomegaly without associated lymphadenopathy. Laboratory findings showed increased levels of lactate dehydrogenase, C-reactive protein, ferritin and soluble interleukin-2 receptor. Histopathologically, hemophagocytosis was often seen in the bone marrow and spleen. Various percentages of lymphoma cells were seen in the bone marrow, positive for CD19, CD20 and surface immunoglobulin. and some were also positive for CD5. Cytogenetic analysis showed a complex structural abnormality including chromosome 14q32, 19q13 and deletion of the terminal part of 8p21. Some patients had histological features of intravascular lymphomatosis (IVL). The prognosis was poor with a median survival period of 9 months. We treated five patients using autologous peripheral blood stem cell transplantation (PBSCT), and four are still in complete remission nine to 24 months after PBSCT, suggesting that high-dose chemotherapy followed by PBSCT might improve the survival rate.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- CD5 Antigens/immunology
- Chromosome Aberrations
- Chromosome Disorders
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 19
- Chromosomes, Human, Pair 8
- Combined Modality Therapy
- Female
- Hematopoietic Stem Cell Transplantation
- Histiocytosis, Non-Langerhans-Cell/etiology
- Histiocytosis, Non-Langerhans-Cell/genetics
- Histiocytosis, Non-Langerhans-Cell/immunology
- Histiocytosis, Non-Langerhans-Cell/therapy
- Humans
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/therapy
- Male
- Middle Aged
- Transplantation, Autologous
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Affiliation(s)
- C Shimazaki
- Second Department of Medicine, Kyoto Prefectural University of Medicine, Kamigyoku, Japan
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Iwatsuki K, Xu Z, Ohtsuka M, Kaneko F. Cutaneous lymphoproliferative disorders associated with Epstein-Barr virus infection: a clinical overview. J Dermatol Sci 2000; 22:181-95. [PMID: 10698155 DOI: 10.1016/s0923-1811(99)00084-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Epstein Barr virus (EBV) infection is implicated in various kinds of neoplasms including certain types of cutaneous T or natural killer (NK) cell proliferative disorders. Although a pathogenic role of EBV infection is not clear, some EBV gene products expressed during a latency phase were found to have biological properties leading to cellular gene expression and immortalization. Furthermore, EBV can use an array of strategies to evade host immune responses, and maintain the latent infection. EBV-associated cutaneous lymphoproliferative disorders are prevalent in Asia, and less frequent in western countries where infectious mononucleosis is common in adolescents and young adults. This review introduces recent advances on the mechanism of EBV infection, highlighting unique clinicopathologic manifestations of EBV-associated cutaneous lymphoproliferative disorders.
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Affiliation(s)
- K Iwatsuki
- Department of Dermatology, Fukushima Medical University School of Medicine, Japan.
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23
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Abstract
Both the REAL and EORTC classification schemes classify lymphomas according to their cell of origin. These schemata also incorporate clinical features that allow for the distinction of some of these disorders. The EORTC classification scheme for primary cutaneous tumors uses terminology similar to that of the REAL classification and should allow for the recognition of teleologically similar tumors in cutaneous and extracutaneous sites. Future investigations will no doubt yield information regarding the true nature of the low-grade B-cell lymphomas of the skin and sort out the ever-increasing number of tumors found to express CD30. Most important, the continued expansion of knowledge regarding cutaneous lymphomas should enhance the ability of physicians to predict prognosis and to arrive at the most effective therapy for patients with these diseases.
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Affiliation(s)
- L M Duncan
- Dermatopathology Unit, Harvard Medical School, Massachusetts General Hospital, Boston, USA.
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24
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Iwatsuki K, Xu Z, Takata M, Iguchi M, Ohtsuka M, Akiba H, Mitsuhashi Y, Takenoshita H, Sugiuchi R, Tagami H, Kaneko F. The association of latent Epstein-Barr virus infection with hydroa vacciniforme. Br J Dermatol 1999; 140:715-21. [PMID: 10233328 DOI: 10.1046/j.1365-2133.1999.02777.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients with hydroa vacciniforme (HV)-like eruptions and malignant potential have been reported from Asia and Mexico, and those patients frequently had an associated latent Epstein-Barr virus (EBV) infection. In order to elucidate the association of latent EBV infection with HV, we studied six children with typical manifestations of HV by detection of EBV genes and EBV-related RNAs in biopsy specimens from cutaneous lesions. Cutaneous lesions of all six children with typical HV contained EBV-encoded small nuclear RNA (EBER)+ cells in 3-10% of the dermal infiltrates, whereas no Bam HI-H, l-fragment (BHLF) mRNA, or transcripts encoding EA-D antigen, were detected. No EBER + cells were detected in other inflammatory or benign lymphoproliferative skin disorders tested. Polymerase chain reaction amplification confirmed the presence of EBV DNA sequences in five of six biopsy specimens from the patients. Latent EBV infection is associated with the development of cutaneous lesions of HV.
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Affiliation(s)
- K Iwatsuki
- Fukushima Medical University School of Medicine, 1-Hikarigaoka, Fukushima 960-1295, USA.
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25
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Shimazaki C, Inaba T, Shimura K, Okamoto A, Takahashi R, Hirai H, Sudo Y, Ashihara E, Adachi Y, Murakami S, Saigo K, Fujita N, Nakagawa M. B-cell lymphoma associated with haemophagocytic syndrome: a clinical, immunological and cytogenetic study. Br J Haematol 1999; 104:672-9. [PMID: 10192425 DOI: 10.1111/j.1365-2141.1999.01239.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
B-cell lymphoma associated with haemophagocytic syndrome (HPS) is extremely rare in Western countries but has recently been increasingly reported in Asian countries. We describe seven patients with B-cell lymphoma associated with HPS, six males and one female, age range 41-82 years (median 63 years). All patients had fever and splenomegaly, and six of the seven patients had hepatomegaly with no associated lymphadenopathy. The bone marrow showed haemophagocytosis and an infiltration of lymphoma cells. All patients showed increased levels of lactate dehydrogenase, C-reactive protein, ferritin and soluble interleukin-2 receptor. Lymphoma cells were positive for CD19. CD20 and surface immunoglobulin in all patients examined, and positive for CD5 in four of seven patients. Cytogenetic analyses of bone marrow cells showed a complex structural abnormality including chromosome 14q32 in two patients, 19q13 in three patients and deletion of the terminal part of 8p21 in six patients. The prognosis was poor; only two of the seven patients have survived in complete remission with a median survival of 11 months. These data suggested that B-cell lymphoma associated with HPS might constitute a distinct biological and clinical disease entity. Abnormality of chromosome 19q13 and loss of 8p21 might be involved in the pathogenesis of this disease.
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Affiliation(s)
- C Shimazaki
- Second Department of Medicine, Kyoto Prefectural University of Medicine, Japan
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26
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Miyamoto T, Yoshino T, Takehisa T, Hagari Y, Mihara M. Cutaneous presentation of nasal/nasal type T/NK cell lymphoma: clinicopathological findings of four cases. Br J Dermatol 1998; 139:481-7. [PMID: 9767295 DOI: 10.1046/j.1365-2133.1998.02414.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Epstein-Barr virus (EBV)-associated T/natural killer (NK) cell lymphoma mainly shows nasal lesions, and has recently been shown to be associated with cutaneous T-cell lymphoma (CTCL). The detailed features of CTCL nasal metastasis have yet to be elucidated. We report clinicopathological findings for four cases of cutaneous T/NK cell lymphoma with metastasis to the nose. The four patients presented progressive involvement of nasal lesions of CTCL, an aggressive course and poor outcome. Their pathological and immunohistological findings were consistent with peripheral T/NK cell neoplasm and, in three of four cases, EBER-1 were apparently detected in lymphoma cells by in situ hybridization, and two of four cases were also positive for TIA-1. The polymerase chain reaction (PCR) results showed the identical band from the skin and nasal lesions of the two patients. We also reviewed the cases of similar clinical course and attempted to elucidate clinical, pathological, immunological and genotypic features. The 10 reported cutaneous T/NK cell lymphomas with nasal metastasis revealed a poor prognosis (nine of 10 died at 3-108 months). Six cases of nine showed a positive reaction to EBV, and six cases revealed T-cell receptor beta or -gamma rearrangement. These findings suggest that most cutaneous T/NK cell lymphoma with nasal metastasis are similar to nasal T-cell lymphoma associated with EBV infection. This type of cutaneous T/NK cell lymphoma likely to involve nasal lesions and skin cases seemed to have a poor prognosis.
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Affiliation(s)
- T Miyamoto
- Department of Dermatology, Tsuyama Central Hospital, 67 Nikaimachi, 708 Tsuyama, Japan
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27
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Chang YT, Liu HN, Chen CL, Chow KC. Detection of Epstein-Barr virus and HTLV-I in T-cell lymphomas of skin in Taiwan. Am J Dermatopathol 1998; 20:250-4. [PMID: 9650697 DOI: 10.1097/00000372-199806000-00005] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Viral etiology has been associated with the pathogenesis of T-cell lymphomas of skin (TCLS). Therefore, we studied the presence of Epstein-Barr virus (EBV) and type I human T-cell lymphotropic virus (HTLV-I) in tumor cells of TCLS to determine the significance of these viruses with the disease. A retrospective study was conducted on the skin tissues from 28 Chinese patients with TCLS. We used in situ hybridization, immunohistochemistry, and polymerase chain reaction to determine the presence of viruses. Among the 28 cases, HTLV-I was only detected in two cases with adult T-cell leukemia/lymphoma, not in other cases of TCLS. This suggests that HTLV-I may not play a significant role in the oncogenesis of TCLS in Chinese patients. Conversely, EBV was detected in 12 cases (42.9%), including the secondary TCLS, large cell lymphoma, mycosis fungoides, adult T-cell leukemia/lymphoma, and angiocentric lymphoma. Nevertheless, latent membrane protein 1 was not detected in any of the EBV-positive cases. Neither was any correlation found between the presence of EBV in TCLS and the prognosis or the severity of the skin lesion. Although there is a close association of EBV with a portion of TCLS, its pathogenic role needs further investigation.
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Affiliation(s)
- Y T Chang
- Department of Dermatology, Veterans General Hospital-Taipei, National Yang-Ming University, Taiwan
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28
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Romano G, Guan M, Long WK, Henderson EE. Differential effects on HIV-1 gene regulation by EBV in T lymphocytic and promonocytic cells transduced to express recombinant human CR2. Virology 1997; 237:23-32. [PMID: 9344904 DOI: 10.1006/viro.1997.8764] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A panel of human hematopoietic cell lines was genetically engineered to express recombinant complement receptor 2 (CR2 or CD21), which is also the Epstein-Barr virus (EBV) receptor. The panel was composed of SupT1, J1.1, and U1.HIV cells. The latter is a promonocytic cell line, whereas the other two are T lymphocytic cell lines. J1.1 and U1.HIV cells are latently infected by human immunodeficiency virus type 1 (HIV-1). These three cell lines were transduced with a murine leukemia virus (MLV)-based retroviral vector system. CR2 was efficiently and consistently expressed on the cell membranes, conferring enhanced susceptibility to EBV infection. The efficient expression of recombinant CR2 in cell lines of hematopoietic origin allowed for study of the interaction between EBV infection and HIV-1 gene regulation in suitable cell-culture models. The effects of EBV and HIV-1 coinfection results were cell-type dependent. In the two T lymphocytic cell lines, HIV-1 expression was rapidly and persistently down-regulated by EBV. Conversely, in the promonocytic cell line U1.HIV-CR2, HIV-1 expression was transiently enhanced by EBV. The EBV and HIV-1 coinfection result in U1.HIV-CR2 cells is potentially important, as the activation of HIV-1 gene expression in monocyte-like cells may play a crucial role in the mechanism of CD4+ T cell depletion by apoptosis. Therefore, the U1.HIV-CR2 cell line may represent a useful cell-culture system to study the synergism between EBV and HIV-1 in inducing apoptosis in primary CD4+ T cells.
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Affiliation(s)
- G Romano
- Department of Microbiology and Immunology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
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29
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CHANG Y, LIU H, WONG C, CHOW K, CHEN K. Detection of Epstein-Barr virus in primary cutaneous amyloidosis. Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb03919.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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30
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Baselga E, Pujol RM, Costa I, Bordas R, De Moragas JM. Subcutaneous angiocentric T-cell lymphoma associated with fatal hemophagocytic syndrome. Int J Dermatol 1997; 36:363-7. [PMID: 9199986 DOI: 10.1111/j.1365-4362.1997.tb03099.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- E Baselga
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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31
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Ohtake N, Setoyama M, Fukumaru S, Kanzaki T. A case of adult T-cell leukemia/lymphoma (ATLL) with angiocentric and angiodestructive features. J Dermatol 1997; 24:165-9. [PMID: 9114613 DOI: 10.1111/j.1346-8138.1997.tb02765.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This report describes a case of adult T-cell leukemia/lymphoma (ATLL) with angiocentric and angiodestructive features. The patient was a 66-year-old Japanese woman who began developing widespread skin lesions ten months prior to admission. The diagnosis of ATLL was made on the basis of her having an antibody to human T-cell lymphotropic virus type-1 (HTLV-1) and typical flower cells (ATLL cells) in peripheral blood smears. Once hospitalized, the course of her disease was very acute and severe, as is seen with angiocentric lymphoma. Based on histological features, this case was judged not to be angiocentric lymphoma; however, it may lie within the spectrum of angiocentric immunoproliferative lesions (AIL). The findings in this case strongly suggest that HTLV-1 can be a pathogenic factor in the expression of angiocentric and angiodestructive features in ATLL, as is Epstein-Barr virus (EBV) (1-4). To our knowledge the present case is the sixth reported in the literature of lymphoma in which these features are associated with HTLV-1 infection (5-7).
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Affiliation(s)
- N Ohtake
- Department of Dermatology, Kagoshima University Faculty of Medicine, Japan
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32
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Abstract
We describe a patient with severe fatal histiocytic phagocytic panniculitis caused by a pleomorphic T-cell lymphoma. Analysis by polymerase chain reaction revealed clonality for both the T-cell receptor gamma-chain gene and the immunoglobulin heavy-chain gene. We also review 44 reported cases of primary or secondary lymphoma affecting the subcutaneous fat.
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33
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MISAGO N, OHSHIMA K, AIURA S, KIKUCHI M, KOHDA H. Primary cutaneous T-cell lymphoma with an angiocentric growth pattern: association with Epstein-Barr virus. Br J Dermatol 1996. [DOI: 10.1111/j.1365-2133.1996.tb03849.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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34
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Take H, Kubota K, Fukuda T, Shinonome S, Ishikawa O, Shirakura T. An indolent type of Epstein-Barr virus-associated T-cell-rich B-cell lymphoma of the skin: report of a case. Am J Hematol 1996; 52:221-3. [PMID: 8756093 DOI: 10.1002/(sici)1096-8652(199607)52:3<221::aid-ajh16>3.0.co;2-i] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 74-year-old Japanese man presented with systemic lymphadenopathy, hepatosplenomegaly, and erythroderma in December 1991. A characteristic pattern of anti-EBV antibodies was suggestive of latent EBV infection. A skin tumor biopsied in April 1993 contained biclonal EBV genomes diffusely in the infiltrate of polyclonal T cells and monoclonal B cells. The clinical course was rather mild in contrast to that of classical EBV-associated disorders. Our case was considered a rare indolent type of EBV-associated T-cell-rich B-cell lymphoma of the skin.
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Affiliation(s)
- H Take
- Department of Medicine, Kusatsu Branch Hospital, Gunma University School of Medicine, Japan
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35
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CHO K, KIM C, LEE D, SOHN S, KIM D, CHUNG J. An Epstein-Barr virus-associated lymphoproliferative lesion of the skin presenting as recurrent necrotic papulovesicles of the face. Br J Dermatol 1996. [DOI: 10.1111/j.1365-2133.1996.tb06994.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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36
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Angel CA, Slater DN, Royds JA, Nelson SN, Bleehen SS. Absence of Epstein-Barr viral encoded RNA (EBER) in primary cutaneous t-cell lymphoma. J Pathol 1996; 178:173-5. [PMID: 8683385 DOI: 10.1002/(sici)1096-9896(199602)178:2<173::aid-path428>3.0.co;2-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Epstein-Barr virus (EBV) has been associated with various extracutaneous lymphoproliferative diseases and it has been suggested that EBV may have a similar aetiological role in cutaneous T-cell lymphoma. In this study, in situ hybridization was used to investigate the presence of EBV encoded RNAs (EBER-1 and EBER-2) in 37 biopsies from 28 cases of primary cutaneous T-cell lymphoma originating from the U.K. The results showed that EBV had no demonstrable pathogenic role in the lymphomas studied, as EBER was not detected in any case.
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Affiliation(s)
- C A Angel
- Department of Pathology, University of Sheffield Medical School, UK
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37
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Kanavaros P, De Bruin PC, Briere J, Meijer CJ, Gaulard P. Epstein-Barr virus (EBV) in extranodal T-cell non-Hodgkin's lymphomas (T-NHL). Identification of nasal T-NHL as a distinct clinicopathological entity associated with EBV. Leuk Lymphoma 1995; 18:27-34. [PMID: 8580826 DOI: 10.3109/10428199509064919] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
T-cell Non-Hodgkin's lymphomas (T-NHL) can be defined as clonal malignant proliferations related phenotypically and functionally to normal T-cell populations of the lymphoid tissue. There is increasing evidence that T-NHL with similar morphology but originating from different sites differ in their clinical behaviour, immunophenotypic features, oncogene expression and relation with oncogenic viruses such as HTLV-I and EBV. Indeed, it has been shown that the prevalence of EBV in T-NHL is related to the site of origin. Thus, EBV was found in nearly all nasal T-NHL but only in a proportion of primary nodal, lung, gastrointestinal and Waldeyer's ring T-NHL while it was undetectable in most primary cutaneous T-NHL. Besides their constant association with EBV, nasal T-NHL display peculiar clinical, histological, immunophenotypic and genotypic features. They present clinically as lethal midline granuloma and histologically as pleomorphic malignant tumours variably associated with angiocentricity, angioinvasion and necrosis. Moreover, they frequently exhibit extensive loss of T-cell antigens, including CD3 and TCR alpha beta and gamma delta proteins, usually express the Natural Killer (NK)-related CD56 antigen and frequently show absence of clonal rearrangements of TCR beta, gamma and delta loci. Therefore, among T-NHL, nasal T-NHL can be regarded as a distinct clinicopathologic entity associated with EBV, which could be derived either from immature T-cells or from NK cells.
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Affiliation(s)
- P Kanavaros
- Department of Pathology, Henri Mondor Hospital, Créteil, France
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38
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Abstract
The peripheral T-cell lymphomas, presumably derived from various immunocompetent peripheral T-cell system components, form a heterogeneous group of non-Hodgkin's lymphomas. We describe two patients with peripheral T-cell lymphoma primarily involving subcutaneous tissue. They presented with multiple subcutaneous nodules. Skin biopsy specimens in both patients demonstrated a lobular subcutaneous infiltrate. The infiltrate consisted of small and medium-sized atypical lymphoid cells. Both patients had a protracted clinical course before they were diagnosed as having malignant lymphoma. We detected latent Epstein-Barr virus infection in the skin lesions of case 2. Latent Epstein-Barr virus infection might be related to the development of this variant of peripheral T-cell lymphoma.
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Affiliation(s)
- K H Cho
- Department of Dermatology, Seoul National University College of Medicine, Korea
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39
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Angel CA, Slater DN, Royds JA, Nelson SN, Bleehen SS. Epstein-Barr virus in cutaneous lymphomatoid granulomatosis. Histopathology 1994; 25:545-8. [PMID: 7698731 DOI: 10.1111/j.1365-2559.1994.tb01373.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Epstein-Barr virus (EBV) has been associated with various extra-cutaneous lymphoproliferative diseases and it has been suggested that EBV may have a similar aetiological role in the skin. In this study, 10 biopsies from 7 cases of primary cutaneous lymphomatoid granulomatosis have been analyzed, using in situ hybridisation, for the presence of EBV encoded RNAs (EBER-1 and EBER-2). Only one case showed positive staining with the EBER probes and it is concluded that, in the skin, the relationship between EBV and lymphomatoid granulomatosis is variable. The role of EBV as an etiological agent in primary cutaneous lymphomatoid granulomatosis appears less important than in primary respiratory disease.
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Affiliation(s)
- C A Angel
- Department of Pathology, University of Sheffield Medical School, UK
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40
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Kanavaros P, Ioannidou D, Tzardi M, Datseris G, Katsantonis J, Delidis G, Tosca A. Mycosis fungoides: expression of C-myc p62 p53, bcl-2 and PCNA proteins and absence of association with Epstein-Barr virus. Pathol Res Pract 1994; 190:767-74. [PMID: 7831152 DOI: 10.1016/s0344-0338(11)80423-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The expression of C-myc p62, bcl-2, p53, PCNA and EBV-encoded LMP-1 proteins was studied by immunohistochemistry on paraffin-embedded skin specimens from 14 patients with early stage (premycotic erythema and second stage plaques) mycosis fungoides (MF), 21 patients with advanced stage MF (third stage plaques and tumors), 3 patients with Sezary's syndrome (SS) and 3 patients with pleomorphic medium and large cell cutaneous T-cell lymphomas (PML-CTCL). All 41 cases were also screened for the presence of EBV by using RNA in situ hybridization with EBER 1/2 oligonucleotides. Increased expression of C-myc p62, p53 and PCNA proteins was found in PML-CTCL and advanced stages of MF as compared to early stages of MF. These results suggest a relationship between levels of C-myc p62, p53 and PCNA proteins and aggressiveness of the cutaneous T-cell lymphomas. Furthermore, C-myc p62 and bcl-2 proteins were found to be frequently coexpressed in the present series. In view of the background information from in vitro findings and animal models that cooperation of C-myc and bcl-2 is important for lymphomagenesis, our results suggest that coexpression of these oncogenes may be implicated in the pathogenesis and/or the progression of cutaneous T-cell lymphomas. Neither LMP-1 expression nor EBV EBER l/2 transcripts were detected in our series suggesting that EBV is not involved in the pathogenesis of cutaneous T-cell lymphomas.
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Affiliation(s)
- P Kanavaros
- Department of Pathology, University of Crete, Greece
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