Follicular lymphoma with Epstein-Barr virus-associated transformation: A case report and review of the literature.

IF 0.9 Q4 HEMATOLOGY
Yuta Tsuyuki, Kennosuke Karube
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引用次数: 0

Abstract

Follicular lymphoma (FL) is a common type of B-cell lymphoma, accounting for about 20% of all lymphomas. Although FL is primarily characterized by an indolent clinical course, histological transformation (HT) remains one of the significant challenges in managing patients with FL. Here, we present a case of FL with partial large-cell transformation due to Epstein-Barr Virus (EBV) arising in a 50-year-old Japanese woman with no known immunodeficiency. Immunohistochemical studies revealed that medium-sized FL cells expressed CD20, CD10, BCL2, and BCL6, whereas large cells were positive for CD20, and MUM1. In situ hybridization (ISH) revealed large cells to be positive for EBV-encoded small RNA (EBER) and further immunohistochemical investigation demonstrated EBER+ cells to express latent membrane protein 1 (LMP1). The Ki-67 index was about 30% in FL cells, and over 70% in large cells. Fluorescence in situ hybridization for BCL2 combined with EBER-ISH identified BCL2 rearrangement in both EBV-infected large cells and EBV-uninfected FL cells, suggesting these two components were clonally related. These findings indicate that EBV contributes to the transformation of FL. As far as the authors could find, only four previous cases of FL development to EBV-positive aggressive lymphoma have been reported. Further studies are needed to clarify the role of EBV in the HT of FL.

伴有 Epstein-Barr 病毒相关转化的滤泡性淋巴瘤:病例报告和文献综述。
滤泡淋巴瘤(FL)是一种常见的 B 细胞淋巴瘤,约占所有淋巴瘤的 20%。虽然滤泡性淋巴瘤的主要特征是临床过程不活跃,但组织学转化(HT)仍是管理滤泡性淋巴瘤患者的重大挑战之一。在此,我们介绍了一例因爱泼斯坦-巴氏病毒(EBV)导致部分大细胞转化的 FL 病例,患者是一名 50 岁的日本女性,无已知的免疫缺陷。免疫组化研究显示,中等大小的 FL 细胞表达 CD20、CD10、BCL2 和 BCL6,而大细胞则表达 CD20 和 MUM1。原位杂交(ISH)显示大细胞的EBV编码小RNA(EBER)阳性,进一步的免疫组化检查显示EBER+细胞表达潜伏膜蛋白1(LMP1)。FL细胞的Ki-67指数约为30%,大细胞则超过70%。BCL2荧光原位杂交与EBER-ISH相结合,在EBV感染的大细胞和EBV未感染的FL细胞中都发现了BCL2重排,这表明这两种成分在克隆上是相关的。这些发现表明,EBV 对 FL 的转化起了作用。据作者所知,此前仅有四例 FL 发展为 EBV 阳性侵袭性淋巴瘤的报道。要明确EBV在FL HT中的作用,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
25
审稿时长
11 weeks
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