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Blood, 1 April 2001, Vol. 97, No. 7, pp. 2130-2136

NEOPLASIA

Kaposi sarcoma-associated herpesvirus infects monotypic (IgMlambda ) but polyclonal naive B cells in Castleman disease and associated lymphoproliferative disorders

Ming-Qing Du, Hongxiang Liu, Tim C. Diss, Hongtao Ye, Rifat A. Hamoudi, Nicolas Dupin, Véronique Meignin, Eric Oksenhendler, Chris Boshoff, and Peter G. Isaacson

From the Department of Histopathology, Royal Free and University College Medical School, University College London, London, United Kingdom; Cancer Gene Cloning Center, Institute of Cancer Research, Sutton, United Kingdom; Departments of Pathology, Immunology and Hematology, Hôpital Saint-Louis, Paris, France; Department of Dermatology, NADER, Hopital Tarnier-Cochin, Paris, France; The CRC Viral Oncology Group, The Wolfson Institute for Biomedical Research, University College London, London, United Kingdom.

In a previous study, it was shown that the Kaposi sarcoma-associated herpesvirus (KSHV) was specifically associated with monotypic (IgMlambda ) plasmablasts in multicentric Castleman disease (MCD). The plasmablasts occur as isolated cells in the mantle zone of B-cell follicles but may form microlymphoma or frank plasmablastic lymphoma. To determine the clonality and cellular origin of the monotypic plasmablasts, the rearranged Ig genes in 13 patients with KSHV-related MCD, including 8 cases with microlymphomas and 2 with frank lymphomas, were studied. To investigate the role of the interleukin 6 (IL-6) receptor signaling in the pathogenesis of MCD and associated lymphoproliferative disorders, viral IL-6 and human IL-6 receptor expression was examined. KSHV-positive plasmablasts were polyclonal in MCD-involved lymphoid tissues in all cases and microlymphomas in 6 of 8 cases. Monoclonal KSHV-positive plasmablasts were seen in microlymphomas of 2 cases and in both frank lymphomas. Despite their mature phenotype, KSHV-positive plasmablasts did not harbor somatic mutations in the rearranged Ig genes, indicating origination from naive B cells. Viral IL-6 was expressed in 10% to 15% of KSHV-positive plasmablasts, whereas the human IL-6 receptor was expressed in most KSHV-positive cells. Thus, KSHV infects monotypic but polyclonal naive B cells and is associated with a range of lymphoproliferative disorders from polyclonal isolated plasmablasts and microlymphomas to monoclonal microlymphoma and frank plasmablastic lymphomas in MCD patients. Activation of the IL-6 receptor signaling pathway may play a role in differentiation of KSHV-infected naive B cells into plasmablasts and development of lymphoproliferative lesions.

© 2001 by The American Society of Hematology.
 

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