Epstein-Barr virus-associated anaplastic large cell lymphoma in renal transplant patients.
A novel association, Epstein-Barr virus-positive Ki-1+/CD30+ anaplastic large cell non-Hodgkin's lymphoma of B-cell phenotype in immunosuppressed renal transplant recipients is reported. Case 1 involved an aggressive clinical evolution, whereas case 2 followed a more "benign" clinical course. Both lymphomas were Epstein-Barr virus-positive as assessed by in situ hybridization, Southern blot, polymerase chain reaction, and immunohistochemical analysis. Both lymphomas contained a single clonal Epstein-Barr virus terminal-repeat fragment. In case 1, clonality was confirmed by the detection of bi-allelic immunoglobulin (Ig) heavy chain gene rearrangement. Case 2 showed germline Ig genes at presentation and oligoclonal Ig heavy chain gene rearrangements at relapse. These results are consistent with the notion that anaplastic large cell lymphoma might arise in a B cell transformed by Epstein-Barr virus at a very early stage, before Ig gene rearrangement. The latter may occur later in the course of clonal evolution, thus permitting investigators to trace intermediate and late stages within a process of multistep lymphomagenesis and/or tumor progression.
Borisch
B
B
Institute of Pathology, University of Berne, Switzerland.
Gatter
K C
KC
Tobler
A
A
Theilkäs
L
L
Bunch
C
C
Wainscoat
J S
JS
Fey
M F
MF
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D015139:Blotting, Southern; D015342:DNA Probes; D004273:DNA, Neoplasm / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D017730:Ki-1 Antigen; D016030:Kidney Transplantation; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics / Q000276:immunology / Q000382:microbiology*; D008297:Male; D009693:Nucleic Acid Hybridization; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000276:immunology / Q000382:microbiology
D015703:Antigens, CD; D000951:Antigens, Neoplasm; D015342:DNA Probes; D004273:DNA, Neoplasm; D004279:DNA, Viral; D017730:Ki-1 Antigen