Co-infection of human herpesvirus-6 and human herpesvirus-8 in primary cutaneous diffuse large B-cell lymphoma, leg type

Human Herpesvirus 6 and Malignancy: A Review

In order to determine the role of human herpesvirus 6 (HHV-6) in human disease, several confounding factors, including methods of detection, types of controls, and the ubiquitous nature of the virus, must be considered. This is particularly problematic in the case of cancer, in which rates of detection vary greatly among studies. To determine what part, if any, HHV-6 plays in oncogenesis, a review of the literature was performed. There is evidence that HHV-6 is present in certain types of cancer; however, detection of the virus within tumor cells is insufficient for assigning a direct role of HHV-6 in tumorigenesis. Findings supportive of a causal role for a virus in cancer include presence of the virus in a large proportion of cases, presence of the virus in most tumor cells, and virus-induced in-vitro cell transformation. HHV-6, if not directly oncogenic, may act as a contributory factor that indirectly enhances tumor cell growth, in some cases by cooperation with other viruses. Another possibility is that HHV-6 may merely be an opportunistic virus that thrives in the immunodeficient tumor microenvironment. Although many studies have been carried out, it is still premature to definitively implicate HHV-6 in several human cancers. In some instances, evidence suggests that HHV-6 may cooperate with other viruses, including EBV, HPV, and HHV-8, in the development of cancer, and HHV-6 may have a role in such conditions as nodular sclerosis Hodgkin lymphoma, gastrointestinal cancer, glial tumors, and oral cancers. However, further studies will be required to determine the exact contributions of HHV-6 to tumorigenesis.

Primary cutaneous diffuse large B cell lymphoma-other successfully treated by the combination of R-CHOP chemotherapy and surgery: A case report and review of literature

RATIONALE

The occurrence of primary cutaneous diffuse large B cell lymphoma-other (PCDLBCL-O) has been rarely reported in the literature. Its diagnosis is based on histopathological and immunohistochemical examinations. To improve the clinical diagnosis and treatment for PCDLBCL-O, we report a case of PCDLBCL-O successfully treated by the combination of R-CHOP (A chemotherapy protocol consists of cyclophosphamide, doxorubicin, vincristine, prednisone plus Rituximab) chemotherapy and surgery. The clinical manifestations, pathological characteristics, treatment and prognosis of the case were analyzed.

PATIENT CONCERNS

The patient was a 56-year-old female, presenting with red plaques and nodules in her left breast for 6 months.

DIAGNOSES

Based on the clinical manifestation, histopathological and immunohistochemical results, the patient was diagnosed with PCDLBCL-O.

INTERVENTIONS

She was treated with 6 courses of R-CHOP chemotherapy combined with surgical resection.

OUTCOMES

In the present case, fairly good curative effect was appeared with no recurrence within the 3 years' follow-up.

LESSONS

Primary cutaneous diffuse large B cell lymphoma commonly occurs on the legs (leg type), rarely on other sites of the body. The clinical manefestations are so variant that its diagnosis depends on histopathological and immunohistochemical examinations. Like systemic diffuse large B cell lymphoma, patients should be treated with systemic chemotherapy.