TY - JOUR
T1 - Epstein-Barr virus-positive nodular lymphocyte predominant Hodgkin lymphoma
AU - Wang, Shi
AU - Medeiros, L Jeffrey
AU - Xu-Monette, Zijun
AU - Zhang, Shanxiang
AU - O'Malley, Dennis P.
AU - Orazi, Attilio
AU - Zuo, Zhuang
AU - Bueso-Ramos, Carlos E
AU - Yin, Cheng Cameron
AU - Liu, Zhiyu
AU - Miranda, Roberto
AU - Young, Ken He
N1 - Funding Information:
SW is an honorable visiting scholar supported by the National University Hospital, Singapore. ZYXM is a recipient of Harold C. and Mary L. Daily Endowment Fellowships at The University of Texas MD Anderson Cancer Center. KHY is supported by The University of Texas MD Anderson Cancer Center Institutional R & D Fund, an Institutional Research Grant Award, an MD Anderson Lymphoma Specialized Programs of Research Excellence (SPORE) Research Development Program Award, an MD Anderson Myeloma SPORE Research Development Program Award and MD Anderson collaborative funds with Roche Molecular System, Gilead Pharmaceutical, DSI Pharmaceutical, HTG Molecular and Adaptive Biotechnology. This work was also partially supported by National Cancer Institute and National Institute of Health (R01CA138688, 1RC1CA146299, P50CA136411 and P50CA142509), and by the MD Anderson Cancer Center Support Grant CA016672.
PY - 2014/8
Y1 - 2014/8
N2 - Hodgkin lymphoma (HL) is classified into 2 largely distinct subgroups, namely nodular lymphocyte predominant HL (NLPHL) and classic HL (CHL). CHL is further divided into nodular sclerosis, lymphocyte-rich, mixed cellularity (MCCHL) and lymphocyte-depleted (LDCHL) subtypes. In industrialized nations, Epstein-Barr virus (EBV) has been associated with all types of CHL, especially the MCCHL and LDCHL subtypes, but is rare in NLPHL. We report 8 cases of EBV-positive NLPHL occurring in patients in the United States. All 8 patients have no history of immunosuppression and presented with localized or systemic lymphadenopathy. Histologically, 6 cases had a vaguely nodular pattern and 2 cases had a nodular and diffuse pattern. In all cases, lymphocyte predominant (LP) cells were observed in a background of small lymphocytes and histiocytes. Immunohistochemical analysis showed that the LP cells in all cases were positive for CD20, CD79a, PAX5, OCT2, and CD45 and were negative for CD15. CD30 was expressed variably in 7 cases. EBV encoded RNA was present in all LP cells in 5 cases and in a subset of LP cells in 3 cases. One patient was treated with radiation therapy and 7 patients received chemotherapy, including 4 of 7 patients who underwent autologous stem cell transplantation. EBV infection is a rare primary or secondary event in NLPHL that correlates with poorer prognosis and often requires more aggressive therapy. The variable expression of CD30 in most of these cases could be the result of EBV infection.
AB - Hodgkin lymphoma (HL) is classified into 2 largely distinct subgroups, namely nodular lymphocyte predominant HL (NLPHL) and classic HL (CHL). CHL is further divided into nodular sclerosis, lymphocyte-rich, mixed cellularity (MCCHL) and lymphocyte-depleted (LDCHL) subtypes. In industrialized nations, Epstein-Barr virus (EBV) has been associated with all types of CHL, especially the MCCHL and LDCHL subtypes, but is rare in NLPHL. We report 8 cases of EBV-positive NLPHL occurring in patients in the United States. All 8 patients have no history of immunosuppression and presented with localized or systemic lymphadenopathy. Histologically, 6 cases had a vaguely nodular pattern and 2 cases had a nodular and diffuse pattern. In all cases, lymphocyte predominant (LP) cells were observed in a background of small lymphocytes and histiocytes. Immunohistochemical analysis showed that the LP cells in all cases were positive for CD20, CD79a, PAX5, OCT2, and CD45 and were negative for CD15. CD30 was expressed variably in 7 cases. EBV encoded RNA was present in all LP cells in 5 cases and in a subset of LP cells in 3 cases. One patient was treated with radiation therapy and 7 patients received chemotherapy, including 4 of 7 patients who underwent autologous stem cell transplantation. EBV infection is a rare primary or secondary event in NLPHL that correlates with poorer prognosis and often requires more aggressive therapy. The variable expression of CD30 in most of these cases could be the result of EBV infection.
KW - Classical Hodgkin lymphoma
KW - Epstein-Barr virus
KW - Nodular lymphocyte predominant Hodgkin lymphoma
UR - http://www.scopus.com/inward/record.url?scp=84904260805&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904260805&partnerID=8YFLogxK
U2 - 10.1016/j.anndiagpath.2014.03.007
DO - 10.1016/j.anndiagpath.2014.03.007
M3 - Article
C2 - 24852241
AN - SCOPUS:84904260805
SN - 1092-9134
VL - 18
SP - 203
EP - 209
JO - Annals of Diagnostic Pathology
JF - Annals of Diagnostic Pathology
IS - 4
ER -