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Epstein-Barr virus-associated non-Hodgkin's lymphoma in patients infected
with the human immunodeficiency virus [see comments]
D Shibata, LM Weiss, AM Hernandez, BN Nathwani, L Bernstein and AM Levine
Department of Pathology, Los Angeles County University of Southern
California Medical Center 90033.
Lymphoproliferations associated with Epstein-Barr virus (EBV) commonly
arise in settings of immune dysfunction, including human immunodeficiency
virus (HIV) infection. In this study, EBV was associated with 39 of 59
(66%) HIV-related systemic lymphomas. Unlike the lymphoproliferations that
arise in the setting of transplantation, the HIV-related lymphomas were
monoclonal, as evaluated by Ig heavy chain rearrangements and EBV termini
analysis, and associated (40%) with c-MYC rearrangements. Furthermore,
analysis of multiple lymphoma tissues from one autopsy showed evidence that
a single lymphoma clone was responsible for dissemination. The latent EBV
nuclear antigen (EBNA- 1) transcripts detected in the HIV-related lymphomas
were characteristic of the pattern found in Burkitt lymphoma (g1 EBNA1) and
not in transplant-related lymphoproliferations. However, unlike Burkitt
lymphoma, EBV latent membrane-associated protein (LMP) transcripts were
also detected, thereby constituting an EBV expression pattern (g1 EBNA1+,
LMP+) not previously observed in B-cell lymphomas. These findings
demonstrate a high frequency of EBV-associated lymphomas in the setting of
HIV infection that are distinct from the lymphoproliferations that arise
during iatrogenic transplant-associated immuno-suppression or in the
general population. However, it is also apparent that HIV-related lymphomas
are biologically heterogeneous, which may reflect the multiple mechanisms
or steps necessary for eventual malignant transformation.
Volume 81,
Issue 8,
pp. 2102-2109,
04/15/1993
Copyright © 1993 by The American Society of Hematology
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