Lymphadenitis and lymphoproliferative lesions associated with the human herpes virus-6 (HHV-6).
A newly described herpes virus, human herpes virus 6, (HHV-6), has been linked to exanthema subitum but beyond this its pathogenetic impact remains to be determined. A large body of evidence links it to various lymphoproliferative disorders and this study was conducted to identify forms of lymphoproliferation linked to HHV-6. We studied biopsy samples from 32 patients with disorders of the lymphatic system for the presence of HHV-6, both by polymerase chain reaction (PCR) and in-situ hybridization (ISH) methods, as well as Epstein-Barr virus (EBV) viral DNA, clonal rearrangements of the antigen receptor genes and bcl-2 genes. All the specimens were studied morphologically and a clinical follow-up of up to 4 years was obtained. Seven of the 32 patients were positive for HHV-6 DNA and the remainder were negative. Two of these HHV-6 positive specimens, both from elderly persons, showed a similar distinct histological pattern diagnosed as malignant B-cell lymphoma of high grade malignancy. Two other HHV-6-positive specimens were reactive lymphadenopathies occurring in younger adults. In addition, one further specimen with evidence of EBV-involvement was from a patient who died 3 months after biopsy with fatal infectious mononucleosis (IM). These five samples had HHV-6 DNA by PCR and ISH. Two specimens without specific histologic abnormalities showed evidence of HHV-6 only by PCR but not by ISH. Both high grade malignant lymphomas showed clonal proliferations, one of monoclonal B-cells and the other of clonal T-cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Pathology, University of Würzburg, Federal Republic of Germany.
B
B
Borisch
K
K
Ellinger
F
F
Neipel
B
B
Fleckenstein
T
T
Kirchner
M M
MM
Ott
H K
HK
Müller-Hermelink
D000293:Adolescent; D000368:Aged; D001483:Base Sequence; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology* / Q000473:pathology; D008199:Lymphadenitis / Q000382:microbiology* / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D008232:Lymphoproliferative Disorders / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009693:Nucleic Acid Hybridization; D015345:Oligonucleotide Probes; D016133:Polymerase Chain Reaction
D004279:DNA, Viral; D015345:Oligonucleotide Probes