Epstein-Barr virus--associated lymphoproliferative lesions.
From this review of the natural history of EBV infection in humans, it is clear that the virus has evolved to a symbiotic state with humans. Once individuals are infected, EBV establishes a permanent infection that is maintained at a low level by replication of the virus in the oropharyngeal region with subsequent seeding of circulating B-lymphocytes. Individuals with normal immune systems are able to control the pronounced proliferative potential of EBV-infected cells and thus prevent the emergence of lymphoproliferations. Disease states result when the immune system is altered by other infections, developmental conditions, immunosuppressive agents, or debilitating circumstances such as cancer or starvation. In some cases, localized lymphoproliferations resembling large-cell non-Hodgkin's lymphomas can result that are monoclonal by immunoglobulin gene rearrangement studies. Remarkably, many of the localized masses will regress if the immunosuppressive agents or condition can be ameliorated in these individuals. In patients with hereditary immune deficiencies, these localized masses can progress to a fatal disease without further cytogenetic events. Burkitt's lymphoma, which is associated with EBV infection, appears to result when EBV-driven lymphoproliferations undergo cytogenetic translocations involving predominantly chromosome 8. Most of the conditions that are associated with EBV can be diagnosed by accurate application of EBV-serology, examination of peripheral blood films, a careful history and physical examination, and, in some cases, more sophisticated techniques such as the establishment of lymphoblastoid cell lines, EBNA staining, DNA probes, and pedigree analysis.
Harrington
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Department of Pathology and Microbiology, Pediatrics, University of Nebraska Medical Center, Omaha.
Weisenburger
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Purtilo
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D000914:Antibodies, Viral / Q000032:analysis; D002051:Burkitt Lymphoma / Q000473:pathology / Q000648:ultrastructure; D002472:Cell Transformation, Viral; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology / Q000648:ultrastructure; D006801:Humans; D007244:Infectious Mononucleosis / Q000401:mortality / Q000473:pathology; D014412:Tumor Virus Infections / Q000209:etiology* / Q000276:immunology; D014779:Virus Replication
D000914:Antibodies, Viral