title: EBV-positive diffuse large B-cell lymphoma of the elderly is an aggressive post-germinal center B-cell neoplasm characterized by prominent nuclear factor-kB activation.
abstract: Here, we report a retrospective series of 47 EBV-positive diffuse large B-cell lymphoma associated with advanced age. Histopathology allowed to the identification of different histological patterns: cases with polymorphic diffuse large B-cell lymphoma (29 cases), Hodgkin-like (8 cases) and polymorphic lymphoproliferative disorder-like (9 cases) patterns. One case was purely monomorphic diffuse large B-cell lymphoma. We show that this lymphoma type is a neoplasm with prominent classical and alternative nuclear factor-kB pathway activation in neoplastic cells (79% of the cases showed nuclear staining for p105/p50, 74% for p100/p52 and 63% for both proteins), with higher frequency than that observed in a control series of EBV-negative diffuse large B-cell lymphoma (χ(2) <0.001). Most cases showed an activated phenotype (95% non-germinal center (Hans algorithm); 78% activated B cell (Choi algorithm)). Clonality testing demonstrated IgH and/or K/Kde/L monoclonal rearrangements in 64% of cases and clonal T-cell populations in 24% of cases. C-MYC (1 case), BCL6 (2 cases) or IgH (3 cases) translocations were detected by FISH in 18% cases. These tumors had a poor overall survival and progression-free survival (the estimated 2-year overall survival was 40 ± 10% and the estimated 2-year progression-free survival was 36 ± 9%). Thus, alternative therapies, based on the tumor biology, need to be tested in patients with EBV-positive diffuse large B-cell lymphoma of the elderly.
authors.affiliation: Pathology Department, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain. smontes@humv.es
authors.forename: Santiago
authors.initials: S
authors.lastname: Montes-Moreno
authors.forename: Lina
authors.initials: L
authors.lastname: Odqvist
authors.forename: Julio A
authors.initials: JA
authors.lastname: Diaz-Perez
authors.forename: Ana Batlle
authors.initials: AB
authors.lastname: Lopez
authors.forename: Sonia Gonzalez
authors.initials: SG
authors.lastname: de Villambrosía
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazorra
authors.forename: Maria E
authors.initials: ME
authors.lastname: Castillo
authors.forename: Mar
authors.initials: M
authors.lastname: Lopez
authors.forename: Raquel
authors.initials: R
authors.lastname: Pajares
authors.forename: Juan F
authors.initials: JF
authors.lastname: García
authors.forename: Manuela
authors.initials: M
authors.lastname: Mollejo
authors.forename: Francisca I
authors.initials: FI
authors.lastname: Camacho
authors.forename: Carmen
authors.initials: C
authors.lastname: Ruiz-Marcellán
authors.forename: Magdalena
authors.initials: M
authors.lastname: Adrados
authors.forename: Nazario
authors.initials: N
authors.lastname: Ortiz
authors.forename: Renato
authors.initials: R
authors.lastname: Franco
authors.forename: Carlos
authors.initials: C
authors.lastname: Ortiz-Hidalgo
authors.forename: Ana
authors.initials: A
authors.lastname: Suarez-Gauthier
authors.forename: Ken H
authors.initials: KH
authors.lastname: Young
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D018858:Germinal Center / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism* / Q000473:pathology* / Q000821:virology; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D046888:Tissue Array Analysis
chemical_list: D016328:NF-kappa B