Diagnostic application of Epstein-Barr virus-encoded RNA in situ hybridisation.
OBJECTIVE
Epstein-Barr virus (EBV) has been implicated in the pathogenesis of nasopharyngeal carcinoma and a range of proliferative lymphoid conditions. In situ hybridisation (ISH) looking for virus-encoded RNA (EBER) transcripts is performed simply using a commercially available probe. We aimed to examine the application of this test in a routine diagnostic setting.


METHODS
In total, 26 cases in which EBV ISH was requested for diagnostic purposes were examined. We looked at the indication for testing, the result and its implication for the final diagnosis.


RESULTS
Cases were classified into three categories: possible nasopharyngeal carcinoma; possible EBV-related lymphoma; and possible immunodeficiency-associated lymphoproliferative disorder. Six of nine cases of possible nasopharyngeal carcinoma were EBV ISH positive (3/3 primary and 3/6 secondary), confirming the diagnosis. Three of 14 possible lymphoma cases were EBV ISH positive which, along with appropriate ancillary tests, assisted in making the diagnoses of Burkitt's lymphoma, lymphomatoid granulomatosis and extranodal NK/T-cell lymphoma of nasal type. All of three immunodeficiency-associated cases were EBV ISH positive. Two of these were post-transplant lymphoproliferative disorders, monomorphic type. The third case was classified as HIV-related polymorphic lymphoproliferative disorder.


CONCLUSIONS
In our experience, EBV ISH is a straightforward and rapid procedure to perform, giving unequivocal results. Used in the appropriate clinicopathological setting it can be a highly useful ancillary diagnostic aid.
Loughrey
Maurice
M
Department of Pathology, Peter MacCallum Cancer Centre, St Andrew's Place, East Melbourne, Victoria 3002, Australia. maurice.loughrey@petermac.org
Trivett
Melanie
M
Lade
Stephen
S
Murray
William
W
Turner
Hugh
H
Waring
Paul
P
D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis*; D019309:Epstein-Barr Virus Nuclear Antigens / Q000032:analysis; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017403:In Situ Hybridization; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000821:virology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000821:virology; D016133:Polymerase Chain Reaction; D012367:RNA, Viral; D012680:Sensitivity and Specificity
D019309:Epstein-Barr Virus Nuclear Antigens; D012367:RNA, Viral