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Presence of Epstein-Barr virus in extranodal T-cell lymphomas: differences
in relation to site
PC de Bruin, M Jiwa, JJ Oudejans, P van der Valk, P van Heerde, JC Sabourin, G Csanaky, P Gaulard, AL Noorduyn and R Willemze
Department of Pathology, Free University Hospital, Amsterdam, The
Netherlands.
T-cell lymphomas with similar morphology but with different sites of origin
have a different clinical behavior. The theoretical explanation for this
finding originates from the hypothesis that non-Hodgkin's lymphomas (NHLs)
are neoplastic equivalents of immunological reactions involving
tissue-restricted lymphocytes. This hypothesis also implies that T-NHLs
originating from different sites differ in their genesis, and thus may
differ in oncogen expression, expression of adhesion molecules, or presence
of certain DNA/RNA viral sequences. Therefore, we have investigated in
T-cell lymphomas with similar morphology originating from different sites,
ie, nose (n = 5; all pleomorphic small- or medium- and large-cell T-cell
lymphomas [PTL]), skin (PTL, n = 6; anaplastic large-cell [ALCL], n = 11),
gut (PTL, n = 8; ALCL, n = 4), and lung (PTL, n = 6), the presence of
Epstein-Barr virus (EBV) at the DNA, RNA (EBER 1 and EBER 2), and protein
level (LMP-1). A double- staining technique was used to detect EBER 1/2,
LMP-1, and differentiation markers at the single-cell level. High numbers
of EBER 1/2-positive tumor cells (> 100 per medium power field [mpf])
were found in five of five nasal T-cell lymphomas, none of 17 primary
cutaneous T-cell lymphomas, one of 12 gastrointestinal T-cell lymphomas
(ALCL), and two of six pulmonary T-cell lymphomas. These lymphomas are
therefore called EBV-associated lymphomas. In contrast to our earlier
findings in lymph nodes, no extranodal lymphomas were found, with only a
few EBV-positive tumor cells. Five gastrointestinal cases positive for EBV
by polymerase chain reaction (PCR) showed that EBER 1/2 was only found in
sporadic nonneoplastic, ie, reactive lymphocytes. Angiocentricity was
present in 18 PTL and one ALCL, but not associated with the presence of
EBV. These results indicate that the presence of EBV in extranodal T-cell
lymphomas is site-restricted and argues for a different pathogenesis of
T-cell lymphomas with similar morphology but originating from different
sites. The presence of EBV in most tumor cells in these EBV-associated
lymphomas suggests that when present, EBV might be important in the
pathogenesis of these lymphomas.
Volume 83,
Issue 6,
pp. 1612-1618,
03/15/1994
Copyright © 1994 by The American Society of Hematology
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