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Aggressive peripheral T-cell lymphomas containing Epstein-Barr viral DNA: a
clinicopathologic and molecular analysis
IJ Su, HC Hsieh, KH Lin, WC Uen, CL Kao, CJ Chen, AL Cheng, ME Kadin and JY Chen
Department of Pathology, National Taiwan University Hospital, Taipei,
Republic of China.
The Epstein-Barr virus (EBV) has been shown to be associated with
posttransplant lymphoma, Hodgkin's disease, and T-cell lymphoma, in
addition to African Burkitt's lymphoma. In a retrospective study of 56
consecutive cases of T-cell lymphoma, EBV DNA was found by Southern blot
and in situ DNA hybridization in 10 (20%) of 50 peripheral T-cell
lymphomas, but in none of six cases of T-lymphoblastic lymphoma. Peripheral
T-cell lymphomas containing EBV DNA could be subclassified into three
categories according to histology and immunophenotypic studies: (1) T-cell
lymphoma of the helper phenotype, five cases. Two cases had histologic
features resembling angioimmunoblastic lymphadenopathy (AILD). (2) T-cell
lymphoma of the cytotoxic/suppressor phenotype, four cases. AILD-like
features could also be recognized in two cases. Reed-Sternberg-like giant
cells were identified in three cases designated Hodgkin-like T-cell
lymphoma. (3) Angiocentric T-cell lymphoma or lymphomatoid granulomatosis
in one case, initially affecting the skin and nose; no T-cell subset could
be defined. Six of the eight EBV DNA-positive patients tested for serum EBV
antibodies had elevated titers of IgG antiviral capsid antigen (greater
than 640) and/or early antigen (greater than 10). From combined studies of
Southern blot hybridization by using EBV termini fragment probe and in situ
DNA hybridization, the EBV genomes appeared to be clonotypically
proliferated in the neoplastic T cells. The patients in all three groups
usually had prolonged fever preceding the diagnosis, hepatosplenomegaly, an
aggressive clinical course, and poor response to chemotherapy; nine died
with a median survival of only 8 months. We propose that these
EBV-associated aggressive T-cell lymphomas, like human T-cell
leukemia/lymphoma virus-positive T-cell lymphoma, have characteristic
clinicopathologic features and should be treated as a separate disease
entity.
Volume 77,
Issue 4,
pp. 799-808,
02/15/1991
Copyright © 1991 by The American Society of Hematology
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