Epstein-Barr virus-associated proliferative disorder presenting as Hodgkin's lymphoma and developing as aggressive natural killer-cell leukemia 19 years later: a case report of composite lymphoma.
We describe a patient who was diagnosed as having classic Hodgkin's lymphoma at 29 years of age, and aggressive natural killer-cell leukemia at 48 years. He died 42 days later. Hodgkin and Reed-Sternberg cells in the lymph node expressed CD30, CD15, T-cell intracellular antigen-1 (TIA-1), perforin, granzyme B, and Epstein-Barr virus-encoded RNA (EBER). Natural killer-cell leukemia cells in the bone marrow expressed cytoplasmic CD3epsilon, TIA-1, perforin, granzyme B, and EBER, and some neoplastic cells expressed CD56 (123C3). Fluorescence-activated cell sorter (FACS) analysis showed that neoplastic cells expressed CD56. Neither a rearrangement band of the T-cell receptor gene nor that of the immunoglobulin heavy chain gene was detected. Chromosomal abnormalities were noted.
Oka
Kuniyuki
K
Pathology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan. oka-k@gb3.so-net.ne.jp
Nagayama
Reizo
R
Mori
Naoyoshi
N
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D017809:Fatal Outcome; D005434:Flow Cytometry; D004854:Herpesvirus 4, Human; D006689:Hodgkin Disease / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D054066:Leukemia, Large Granular Lymphocytic / Q000276:immunology / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000276:immunology / Q000473:pathology* / Q000821:virology