Characterization of overt B-cell lymphomas in patients with hepatitis C virus infection.
A pathogenetic role of the hepatitis C virus (HCV) has been hypothesized for a subset of B-cell non-Hodgkin's lymphomas (NHLs). However, the preliminary characterization of B-cell NHLs in HCV-infected individuals has been poorly addressed. In the present study, we report detailed information on 35 consecutive patients with overt B-cell NHL of recent onset and HCV infection; all patients referred to a single oncological center in Northeast Italy. Histopathologic evaluation was performed by a single reference hemopathologist, and the link with the two relevant autoimmune diseases predisposing to B-cell NHL and in which HCV has been implied, ie, "essential" mixed cryoglobulinemia (EMC) and Sjogren's syndrome, was investigated. Control groups included 122 consecutive HCV-negative patients with B-cell NHL and 464 consecutive histopathologic cases of B-cell NHL referred to the same center, as well as 127 consecutive patients with HCV infection and without lymphoma referred to a different center in the same geographical area. B-cell NHLs in HCV-infected patients frequently presented at onset (1) an extranodal localization with peculiar target organs of HCV infection (ie, the liver and major salivary glands) being significantly overrepresented; (2) a diffuse large cell histotype without any prior history of low-grade B-cell malignancy or bone marrow involvement; and (3) a weak association with a full-blown predisposing autoimmune disease, although serum autoimmune features were common and cryoglobulins were always present. Therefore, the HCV-related B-cell NHLs in this oncological series presented distinctive features compared with B-cell NHLs in HCV-negative patients, and they differed from bone marrow low-grade NHLs frequently diagnosed in HCV-positive patients with EMC. Such novel information may be relevant for future research aimed at clarifying the possible link between HCV infection, autoimmunity, nonmalignant B-cell lymphoproliferation, and overt B-cell malignancy.
De Vita
S
S
Division of Experimental Oncology 1, Centro di Riferimento Oncologico, Aviano, Italy.
Sacco
C
C
Sansonno
D
D
Gloghini
A
A
Dammacco
F
F
Crovatto
M
M
Santini
G
G
Dolcetti
R
R
Boiocchi
M
M
Carbone
A
A
Zagonel
V
V
D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D001327:Autoimmune Diseases / Q000276:immunology / Q000473:pathology / Q000821:virology*; D003449:Cryoglobulinemia; D004198:Disease Susceptibility; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016130:Immunophenotyping; D007558:Italy; D016393:Lymphoma, B-Cell / Q000276:immunology* / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012859:Sjogren's Syndrome / Q000150:complications / Q000453:epidemiology
D015703:Antigens, CD