Epstein-Barr virus (EBV)-related lymphoproliferative disorder with subsequent EBV-negative T-cell lymphoma

Int J Cancer. 1994 Jul 1;58(1):33-9. doi: 10.1002/ijc.2910580107.

Abstract

A 58-year-old Chinese man presented initially with generalized lymphadenopathy, and lymph-node biopsy showed disturbed architecture with preponderance of large B-blasts mixed with numerous CD8+ T lymphocytes, consistent with an acute Epstein-Barr virus (EBV) infection. Immunohistological and gene rearrangement studies confirmed the absence of clonal T or B cells. Polyclonal EBV with lytic infection was detected by Southern blot hybridization (SoBH). Expression of EBV proteins (EBNA2, LMP and ZEBRA) was detected in a proportion of cells by immunostaining. EBV-lytic proteins EA-D, VCA, MA were also detected in rare scattered cells. Double immunostaining showed that the LMP-positive cells were of B and of T phenotype: 73% CD19+, 26% CD2+, 23% CD3+, 8% CD4+, 17% CD8+. After biopsy, there was spontaneous regression of lymph-node enlargement, but lymphadenopathy recurred 8 months later, and the second lymph-node biopsy showed T-cell lymphoma, confirmed by detection of clonally rearranged T-cell-receptor beta-chain gene. However, EBV genome could not be detected in the second biopsy by SoBH, in situ hybridization for EBV-encoded EBER RNA, and immunostaining for EBNA2, LMP and ZEBRA was also negative. This case is of special interest because an EBV-negative T-cell lymphoma developed shortly after an acute episode of EBV-related lymphoproliferation, even though many EBV-positive T cells were detected during the acute episode. EBV was apparently not a direct cause of the lymphoma, but the close temporal association of the 2 lesions supports the hypothesis that EBV can act as a co-factor in lymphomagenesis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Gene Rearrangement
  • Gene Rearrangement, beta-Chain T-Cell Antigen Receptor
  • Genes, Immunoglobulin
  • Herpesviridae Infections / microbiology*
  • Herpesviridae Infections / pathology
  • Herpesvirus 4, Human* / genetics
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / chemistry
  • Lymph Nodes / immunology
  • Lymph Nodes / pathology
  • Lymphoma, T-Cell / microbiology*
  • Lymphoma, T-Cell / pathology
  • Lymphoproliferative Disorders / microbiology*
  • Lymphoproliferative Disorders / pathology
  • Male
  • Middle Aged
  • RNA, Small Nuclear / analysis
  • RNA, Viral / analysis
  • T-Lymphocytes / microbiology
  • Tumor Virus Infections / microbiology*
  • Tumor Virus Infections / pathology
  • Viral Proteins / analysis

Substances

  • RNA, Small Nuclear
  • RNA, Viral
  • Viral Proteins