Nodal cytotoxic molecule (CM)-positive Epstein-Barr virus (EBV)-associated peripheral T cell lymphoma (PTCL): a clinicopathological study of 26 cases.
OBJECTIVE
The clinicopathological distinctiveness of nodal cytotoxic molecule (CM)-positive Epstein-Barr virus (EBV)-associated peripheral T cell lymphoma (PTCL) remains to be clarified. We investigated 26 patients with this lymphoma compared to nodal CM(+) EBV(-) PTCL (n = 39) and extranasal natural killer/T cell lymphoma of nasal type (ENKTL, n = 44).


RESULTS
Nodal CM(+) EBV(+) PTCL patients were more likely to have B symptoms (P = 0.019) and hepatic involvement (P = 0.026) than nodal CM(+) EBV(-) PTCL patients. The former also had more Stage III/IV disease (P = 0.025) but much less cutaneous involvement (P < 0.001) than ENKTL patients at diagnosis. This nodal EBV(+) lymphoma possessed a distinctive immunophenotype of high CD8(+), CD56(-) pattern with an aggressive clinical course (median, 6.6 months). Thrombocytopenia was present in 11 (50%) patients and found to be the strongest prognostic indicator (P = 0.001) in this nodal EBV(+) group. For all nodal CM(+) PTCL cases CD5 negativity, but not EBV positivity, was the significant adverse prognostic factor (P < 0.002) in a multivariate analysis, independent of prognostic index for PTCL (PIT) or International Prognostic Index (IPI) scores.


CONCLUSIONS
Nodal CM(+) EBV(+) PTCL constitutes a unique group of lymphomas distinct from ENKTL. The data provide support for our assertion that nodal CM(+) PTCL should be distinguished in the 2008 WHO category of PTCL, not otherwise specified.
Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan. katopath@med.nagoya-u.ac.jp
Seiichi
S
Kato
Emiko
E
Takahashi
Naoko
N
Asano
Tsutomu
T
Tanaka
Nirmeen
N
Megahed
Tomohiro
T
Kinoshita
Shigeo
S
Nakamura
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000276:immunology* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000276:immunology* / Q000473:pathology* / Q000821:virology; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D017403:In Situ Hybridization; D053208:Kaplan-Meier Estimate; D054391:Lymphoma, Extranodal NK-T-Cell / Q000276:immunology / Q000473:pathology / Q000821:virology; D016411:Lymphoma, T-Cell, Peripheral / Q000276:immunology* / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D055611:Natural Killer T-Cells / Q000276:immunology / Q000473:pathology; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult
D014408:Biomarkers, Tumor; C099537:Epstein-Barr virus encoded RNA 1; C106732:Epstein-Barr virus encoded RNA 2; D012367:RNA, Viral