Clinicopathologic features and Epstein-Barr virus infection status of Burkitt's lymphoma in Guangzhou district.
OBJECTIVE
Sporadic Burkitt's lymphoma (sBL) is uncommon and its relation to Epstein-Barr virus (EBV) is unknown in China. This study was to investigate the clinical presentation, morphologic features, immunophenotype and EBV infection status of sBL in Guangzhou district, a prevalent area of EBV infection.


METHODS
The clinical data of 21 sBL patients were reviewed. A panel of immunohistochemical staining was performed and EBV-encoded small RNAs (EBERs) in situ hybridization was applied to identify EBV infection.


RESULTS
From January 2000 to October 2007, 21 cases(0.87%) of sBL were confirmed among 2416 cases of non-Hodgkin's lymphoma(NHL) in Sun Yat-sen University Cancer Center. Male to female ratio was 4.25 (17/4). The median age was 23 years. Of the 21 patients, 19 (90.48%) had lymph node(s) involvement; 16 (76.19%) had multiple sites involvement; 12 (57.14%) were at advanced stages (III/IV). The 2-year survival rate of 15 patients who received chemotherapy or resection plus chemotherapy was 56.00%. Twenty cases showed the prototypic morphology of sBL, and one was the variant of sBL with plasmacytoid differentiation. The main immunophenotype of these 21 sBLs was sIgM+/CD20+/CD10+/Bcl-6+/Bcl-2-[or Bcl-6+(>95%)/Bcl-2+(<10%)]/TdT-/Ki-67+ 100%. Of 20 detectable cases, 11 showed CD5 expression in a few (3%-20%) tumor cells. P53 was overexpressed in ten cases (47.62%). Six cases (28.57%) had EBV infection, with EBNA1 and EBERs expression, but not LMP1. There were no significant differences in morphology and immunophenotype between EBV-positive and EBV-negative cases.


CONCLUSIONS
sBL is uncommon in Guangzhou district, mainly seen in boys and young men. Most patients had lymph node(s) involvement, showing similar morphology and immunophenotype as that of endemic BL. Type I EBV latent infection is associated with 28.57% of cases.
Huang
Yu-Hua
YH
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P.R. China.
Wu
Qiu-Liang
QL
Zong
Yong-Sheng
YS
Feng
Yan-Fen
YF
Liang
Jian-Zhong
JZ
Hou
Jing-Hui
JH
Shao
Qiong
Q
Fu
Jia
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002051:Burkitt Lymphoma / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D002681:China; D004268:DNA-Binding Proteins / Q000378:metabolism; D020031:Epstein-Barr Virus Infections / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D019309:Epstein-Barr Virus Nuclear Antigens / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D050835:Interferon Regulatory Factors / Q000378:metabolism; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015260:Neprilysin / Q000378:metabolism; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051560:Proto-Oncogene Proteins c-bcl-6; D012367:RNA, Viral / Q000378:metabolism; D015996:Survival Rate; D055815:Young Adult; D000099218:Interferon Regulatory Factor-4
D004268:DNA-Binding Proteins; D019309:Epstein-Barr Virus Nuclear Antigens; D050835:Interferon Regulatory Factors; D007770:L-Lactate Dehydrogenase; D015260:Neprilysin; D019253:Proto-Oncogene Proteins c-bcl-2; D051560:Proto-Oncogene Proteins c-bcl-6; D012367:RNA, Viral; D000099218:Interferon Regulatory Factor-4; C084103:BCL6 protein, human; C099537:Epstein-Barr virus encoded RNA 1; C417029:EBV-encoded nuclear antigen 1