Hodgkin's disease and peripheral T-cell lymphoma: composite lymphoma with evidence of Epstein-Barr virus infection.
This paper reports the case of a patient with a composite lymphoma consisting of nodular sclerosing Hodgkin's disease and peripheral T-cell lymphoma. The Hodgkin and Reed-Sternberg (HRS) cells harboured the Epstein-Barr virus (EBV) and displayed a type II EBV latency (LMP1(+)/EBNA2(-)), whereas the neoplastic T-cells were EBV-negative. Four years later, the patient presented with a relapse of the peripheral T-cell lymphoma. In situ hybridization revealed numerous EBV-carrying lymphocytes, which were shown to be polyclonal B-cells with a latency III pattern of EBV gene expression (LMP1(+)/EBNA2(+)). This observation suggests that impairment of EBV-specific immunity in the micro-environment of T-cell lymphomas may facilitate the outgrowth of EBV-carrying B-lymphocytes and emphasizes the importance of determining the phenotype of EBV-infected cells, particularly when studying T-cell lymphomas. The results further suggest that the HRS cells and neoplastic T-cells were of different clonal origins. The detection of EBV-carrying cell populations admixed with the neoplastic T-cells at primary presentation and at relapse raises the possibility that the growth of the T-cell lymphoma was dependent on the presence of such cells.
Institute for Pathology, Friedrich-Alexander University, 91054 Erlangen, Germany. gerald.niedobitek@patho.imed.uni-erlangen.de
G
G
Niedobitek
I
I
Baumann
T
T
Brabletz
R
R
Lisner
C
C
Winkelmann
G
G
Helm
T
T
Kirchner
D000368:Aged; D001402:B-Lymphocytes / Q000821:virology; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000378:metabolism; D017809:Fatal Outcome; D015870:Gene Expression; D005814:Genes, Viral; D004854:Herpesvirus 4, Human / Q000235:genetics; D006689:Hodgkin Disease / Q000150:complications* / Q000378:metabolism; D006801:Humans; D017403:In Situ Hybridization; D016411:Lymphoma, T-Cell, Peripheral / Q000150:complications* / Q000378:metabolism; D008297:Male; D010641:Phenotype; D016133:Polymerase Chain Reaction