lewis-x-antigen and Epstein-Barr-Virus-Infections

Epstein-Barr virus (EBV) can be associated with both classical Hodgkin lymphoma (cHL) and non-Hodgkin lymphoma of the B-cell type, particularly in immunodeficient patients or elderly individuals. While polymorphic variants of EBV-positive large B-cell lymphoma (EBV+ DLBCL) frequently resemble cHL in morphology, and thereby may cause diagnostic difficulty, a true gray zone lymphoma with overlapping morphological and immunophenotypical features of EBV+ DLBCL and EBV+ cHL has not been reported in the literature. We describe a unique case of an EBV+ malignant lymphoma of B-cell origin with hybrid features of EBV+ DLBCL and EBV+ cHL in a 67-year-old female without an identifiable etiology for immunodeficiency. The biopsy of an enlarged lymph node showed a polymorphic infiltrate containing Reed-Sternberg-like pleomorphic large cells, which were positive for CD30 and CD15. Although CD20 was negative and PAX5 and CD45 were down-regulated, the pleomorphic large cells expressed multiple other B-cell antigens which are characteristically absent in cHL. EBV-encoded RNA hybridization (EBER) studies demonstrated nuclear reactivity in the large cells as well as in the smaller bystander cells. A clonal rearrangement of the immunoglobulin heavy chain gene was also detected by PCR. Although the results of the EBV and genotypic studies suggest this case may be an example of EBV+ DLBCL of the elderly instead of EBV+ cHL, the immunophenotype is strikingly ambiguous. Thus, this case may represent an interface between EBV+ DLBCL and EBV+ cHL.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Doxorubicin; Epstein-Barr Virus Infections; Etoposide; Female; Gene Rearrangement, B-Lymphocyte, Heavy Chain; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Lymphoma, Large B-Cell, Diffuse; Prednisone; Procarbazine; Reed-Sternberg Cells; Remission Induction; Vincristine

Epstein-Barr virus (EBV) may cause post-transplant lymphoproliferative disorder, but most EBV infections after liver transplantation (Ltx) are clinically silent reactivations. In this study, we investigated the intragraft immunological events associated with EBV DNAemia. Altogether, 105 adult Ltx patients were monitored for EBV DNAemia. Fourteen (13%) patients developed EBV DNAemia during the first year after transplantation. Liver biopsies obtained associated with EBV DNAemia, without evidence of other herpes or hepatitis viruses or rejection, were available from five patients. The numbers of lymphocytes positive for B-cell marker (CD20), T-cell markers (CD3, CD4 and CD8) and IL-2R, adhesion molecules (ICAM-1, VCAM-1 and ELAM-1) and their ligands [lymphocyte function-associated antigen-1 (LFA-1), very late antigen (VLA-4) and Sialyl Lewis X (sLeX)] were demonstrated in liver biopsies by immunohistochemistry, and zero-biopsies from donor livers were used as controls. EBV DNAemia was associated with increased number of CD20-positive (22±30, p=0.09) and significantly increased numbers of CD3 (80±16, p=0.001)-, CD4 (23±8, p=0.009)- and CD8 (38±8, p=0.001)-positive lymphocytes in the graft. ICAM-1, but not VCAM-1 or ELAM-1, was strongly expressed and the number of LFA-1-positive cells was significantly increased (48±10, p=0.0002). Low-level EBV DNAemia was associated with B- and especially T-cell infiltration of the graft, as well as an increase in ICAM-1 and the number of LFA-1-positive cells. However, EBV DNAemia or these immunological events did not have any effect on the liver transplant.

Topics: Adult; Antigens, CD; B-Lymphocytes; Cell Adhesion Molecules; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Integrin alpha4beta1; Lewis X Antigen; Liver Transplantation; Lymphocyte Function-Associated Antigen-1; Male; Sialyl Lewis X Antigen; Transplantation, Homologous

The peripheral giant cell granuloma is a relatively common non-neoplastic inflammatory lesion of gingiva, but the etiopathogeny remains unknown. This study aimed to evaluate the importance of human cytomegalovirus and Epstein-Barr virus in a peripheral giant cell granuloma of a 47-year-old female.. The lesion was studied clinically, histopathologically, immunologically and virologically using established procedures.. The gingival growth was located at the mesial surface of the maxillary left canine having a vital pulp. The mass was 12 x 21 mm in size and exhibited a smooth surface with no evidence of fluctuation on palpation. An excisional biopsy revealed giant cells in a fibrohistiocytic stroma with areas of haemorrhage. Serum protein levels and lymphocyte subsets were within normal limits, except CD3(+) and CD4(+) cells were below normal ranges. Polymorphonuclear leukocytes expressed p150,95 (CD11c/CD18) and CXCR-2 receptors within normal ranges, but the CXCR1 receptor showed decreased density, and CD15 were below normal range. A virological sample of the tooth surface adjacent to the gingival swelling yielded 7.6 x 10(3) copy-counts of cytomegalovirus and 4.3 x 10(3) copy-counts of Epstein-Barr virus.. The clinical and histological findings were consistent with the diagnosis of peripheral giant cell granuloma. Cytomegalovirus has the potential to induce multinucleated giant cells, and the possibility that the virus contribute to the development of peripheral giant cell granuloma merits further study.

Topics: Biopsy; CD3 Complex; CD4-Positive T-Lymphocytes; Cuspid; Cytomegalovirus; Cytomegalovirus Infections; Epstein-Barr Virus Infections; Female; Gingival Diseases; Granuloma, Giant Cell; Herpesvirus 4, Human; Humans; Lewis X Antigen; Middle Aged; Neutrophils; Receptors, Interleukin-8A; T-Lymphocytes

The burden of lymphomas on the health care system in Nigeria is enormous. Correct diagnosis and identification of aetiological factor are important steps in reducing this burden.. Eight cases diagnosed as HL within a period of six years at the Obafemi Awolowo University teaching Hospital, Ile-Ife, Nigeria by haematoxylin and eosin (Hand E) only were immunophenotyped using the indirect immunoperoxidase method. Epstein-Barr virus latent membrane protein-1 (LMP-1), CD15 and CD30 immunohistochemistry was also performed. The clinical characteristics of each patient were documented.. To document the frequency of involvement of Epstein-Barr virus in cases of HL seen in a university hospital in Nigeria.. Out of the eight cases diagnosed by H&E as HL immunophenotyping showed only five were HL. The rest were non-Hodgkin's lymphoma (2 diffuse large B-cell and 1 null cell ALCL). All were cases of classical HL with 60% being of the mixed cellularity (MC) subtype. There were 2 males and 3 females with ages ranging from 7 years to 40 years. All presented with cervical lymphadenopathy and three had splenomegaly in addition. 60% of the tumour was EBV positive, all of the MC subtype. Three patients had chemotherapy. Eventually all were lost to follow-up. There was no case of the nodular lymphocyte predominance variant.. Mixed cellularity is the most common subtype and is the only subtype associated with EBV positivity in this study. Epstein-Barr virus probably plays an important role in the aetiology of HL in Nigerians.

Topics: Adolescent; Adult; Biomarkers, Tumor; Child; Epstein-Barr Virus Infections; Female; Hodgkin Disease; Hospitals, Teaching; Humans; Immunohistochemistry; Immunophenotyping; Ki-1 Antigen; Lewis X Antigen; Male; Nigeria; Viral Matrix Proteins; Young Adult

Topics: Adult; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Antigens, CD; Antigens, CD20; Antineoplastic Agents; CD79 Antigens; Cell Differentiation; Chromosome Deletion; Chromosomes, Human, Pair 6; Epstein-Barr Virus Infections; fas Receptor; Hodgkin Disease; Humans; Immunohistochemistry; Ki-1 Antigen; Kidney Transplantation; Leukocyte Common Antigens; Lewis X Antigen; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Lymphoproliferative Disorders; Male; Postoperative Complications; Receptors, Antigen, B-Cell; Rituximab; Treatment Outcome

Neoplastic cells in classical Hodgkin's lymphomas (cHL) seem to correspond to defective germinal center B-cells, which escape from apoptosis. Epstein-Barr virus (EBV) may be implicated in this protective mechanism. The aim of the present study was to determine the expression of apoptosis-related proteins in cHL among adult patients and correlate them with EBV expression, clinical findings and survival. EBV was detected by in situ hybridization (Epstein-Barr Encoded RNA, EBER, probe). Immunohistochemistry was used on paraffin sections to detect LMP-1/EBV, CD15 and the apoptosis-related proteins (bcl-2, bax, bcl-X, mcl-1 and CD95). Seventy-eight patients seen at our Institution were studied: 36 male and 42 female. Median age was 31 years (15-75 years). Histological types of cHL were: 61 nodular sclerosis (47 NS1 and 14 NS2), 15 mixed cellularity (MC), 1 lymphocyte depletion and 1 unclassified. In 50 cases there was EBV expression (64%). At least one apoptosis-associated protein was expressed in 92% and CD15 in 57.7% of the cases. In the univariate analysis, the following variables were related to a better overall survival: expression of CD15 (p = 0.023), expression of mcl-1 protein (p = 0.029), expression of bcl-2 protein (p = 0.028, only in a Cox model after stratification for histology) and expression of LMP-1 (p = 0.042). EBV expression presented a borderline inverse correlation with bcl-2. A prognostic index (PI) developed in the present study revealed that simultaneous expression of bcl-2, mcl-1 and LMP-1 was significant and independently correlated with an excellent survival.

Topics: Adolescent; Adult; Aged; Apoptosis; bcl-2-Associated X Protein; bcl-X Protein; Biomarkers; Epstein-Barr Virus Infections; fas Receptor; Female; Hodgkin Disease; Humans; Lewis X Antigen; Life Tables; Male; Middle Aged; Myeloid Cell Leukemia Sequence 1 Protein; Neoplasm Proteins; Prognosis; Proportional Hazards Models; Proto-Oncogene Proteins; Proto-Oncogene Proteins c-bcl-2; Retrospective Studies; RNA, Viral; Survival Analysis; Tumor Virus Infections; Viral Matrix Proteins

We report a rare case of primary pulmonary Hodgkin's lymphoma associated with Epstein-Barr virus (EBV) and cytomegaly virus (CMV) infections as demonstrated by in situ hybridisation method. Reed-Sternberg cells were CD30 positive. Numerous CD15+ cells were noticed, some of them with concomitant CMV infection.

Topics: Cytomegalovirus; Cytomegalovirus Infections; Diagnosis, Differential; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lung Neoplasms; Lymphoma, B-Cell; Lymphoma, Large B-Cell, Diffuse; Lymphoma, T-Cell; Middle Aged; Reed-Sternberg Cells; Tomography, X-Ray Computed

Paraffin blocks and clinical data from 521 patients with lymphocyte predominance Hodgkin disease (LPHD) diagnosed between 1970 and 1994 were collected from 16 European and United States oncological centers to establish the pathologic and clinical characteristics of a large patient cohort, to determine how frequent T-cell-rich large B-cell lymphoma (TCRLBCL) is among LPHD, and to find differential diagnostic criteria distinguishing between the 2 lymphoma categories. For this purpose, conventionally and immunohistologically stained sections were reviewed by a panel of hematopathologists. The diagnosis of LPHD was confirmed in only 219 of the 388 assessable cases (56.5%). This low confirmation rate was due mainly to the presence of a new variant of classical Hodgkin disease (CHD), which resembled, in terms of nodular growth and lymphocyte-richness, nodular LPHD and, in terms of the immunophenotype of the tumor cells, CHD and was designated nodular lymphocyte-rich CHD (NLRCHD). The nodules of LRCHD consisted-as in nodular LPHD-predominantly of B cells but differed from those present in LPHD in that they represented expanded mantle zones with atrophic germinal centers. Clinically, patients with LPHD and NLRCHD showed similar disease characteristics at presentation but differed in the frequency of multiple relapses and prognosis after relapse. Patients with LPHD and NLRCHD clearly differed from patients with CHD with nodular sclerosis or mixed cellularity, as they presented with an earlier disease stage and infrequent mediastinal involvement. As 97% of the LPHD cases showed a complete or partial nodular growth pattern, their differentiation from TCRLBCL was a rare problem in the present series. (Blood. 2000;96:1889-1899)

Topics: Adolescent; Adult; Antigens, CD20; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Hodgkin Disease; Humans; Immunohistochemistry; Immunophenotyping; In Situ Hybridization; Ki-1 Antigen; Lewis X Antigen; Lymphocytes; Lymphoma; Male; Middle Aged; Neoplasm Staging; RNA, Viral; Survival Analysis