title: Age-related EBV-associated B-cell lymphoproliferative disorders: diagnostic approach to a newly recognized clinicopathological entity.
abstract: EBV is prevalent among healthy individuals, and is implicated in numerous reactive and neoplastic processes in the immune system. The authors originally identified a series of senile or age-related EBV-associated B-cell lymphoproliferative disorders (LPD) bearing a resemblance to immunodeficiency-associated ones, which may be associated with immune senescence in the elderly and which are now incorporated into the 2008 World Health Organization lymphoma classification as EBV-positive diffuse large B-cell lymphoma (DLBCL) of the elderly. This newly described disease is pathologically characterized by a proliferation of atypical large B cells including Reed-Sternberg-like cells with reactive components, which pose a diagnostic problem for pathologists. Clinically, this disease may present with lymphadenopathy, and is often extranodal, frequently involving the skin, gastrointestinal tract, or lung. Onset is usually after the age of 50; the median patient age is 70-79 years, and incidence continues to increase with age, providing additional support to the nosological term of EBV+ DLBCL of the elderly. These patients have a worse prognosis than those with EBV-negative DLBCL or EBV+ classical Hodgkin lymphoma (CHL). The aim of the present review was to summarize the clinicopathological profile of age-related EBV+ LPD and EBV+ Hodgkin lymphoma to facilitate diagnostic approach.
authors.affiliation: Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Shimoyama
authors.forename: Naoko
authors.initials: N
authors.lastname: Asano
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Satoko
authors.initials: S
authors.lastname: Morishima
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Oyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020031:Epstein-Barr Virus Infections / Q000473:pathology*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000473:pathology* / Q000821:virology*; D008232:Lymphoproliferative Disorders / Q000473:pathology / Q000821:virology; D008875:Middle Aged