[Epstein-Barr virus-associated malignant lymphoma in an immuno-deficiency patient: a case report].
Human infection with Epstein-Barr (EB) virus occurs commonly, and EB virus exists in the B cell as a cryptic infection. Infected B cells become immortal by expressing both the EBNA2 and the LMP1 genes derived from the EB virus. Under normal condition of cellular immunity, the T cells recognize the EBNA2 and LMP1 as foreign proteins and attack the immortal B cells. However, under the condition of immunodeficiency, the immortal B cells can proliferate and form a tumor. We report a case of malignant lymphoma associated with immuno-deficiency which may correspond to this mechanism. A 33-year-old woman, who had an immuno-deficiency due to treatment for leukemia, had a progressing hemiparesis on her left extremities. Magnetic resonance imagings revealed a ring enhanced tumor with massive brain edema in the right fronto-parietal lobe. Stereotactic biopsy was performed and histological examination showed it to be a malignant lymphoma. The tumor cells were positive for L26 (B cell marker), CD79a LMP1, and EBNA2. They were negative for UCHL-1 and CD3 (T cell marker). According to these results, this lymphoma was caused by EB virus infection under the condition of immuno-deficiency.
Inamura
T
T
Department of Neurosurgery, Neurological Institute, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Nishio
S
S
Matsukado
K
K
Nagafuji
H
H
Ikezaki
K
K
Morioka
T
T
Fukui
M
M
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D004720:Endonucleases; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications*; D016393:Lymphoma, B-Cell / Q000209:etiology / Q000821:virology*; D009687:Nuclear Proteins / Q000235:genetics; D014763:Viral Matrix Proteins / Q000235:genetics
D004279:DNA, Viral; C037662:EBV-associated membrane antigen, Epstein-Barr virus; D009687:Nuclear Proteins; D014763:Viral Matrix Proteins; D004720:Endonucleases; C095221:SND1 protein, human