EBV-Positive T/NK-Cell Lymphoproliferative Disease of Childhood.
- Author:
Mineui HONG
1
;
Young Hyeh KO
;
Keon Hee YOO
;
Hong Hoe KOO
;
Seok Jin KIM
;
Won Seog KIM
;
Heejung PARK
Author Information
1. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yhko310@skku.edu
- Publication Type:Original Article
- Keywords:
Epstein-Barr virus infections;
Lymphoma, T-cell;
Killer cells, natural;
Lymphoproliferative disorders;
Clonality
- MeSH:
Epstein-Barr Virus Infections;
Gene Rearrangement;
Genes, T-Cell Receptor;
Herpesvirus 4, Human;
Histiocytosis;
Humans;
Hydroa Vacciniforme;
Hypersensitivity;
Killer Cells, Natural;
Lymphocytes;
Lymphocytosis;
Lymphohistiocytosis, Hemophagocytic;
Lymphoma, T-Cell;
Lymphoproliferative Disorders;
Receptors, Antigen, T-Cell;
T-Lymphocytes
- From:Korean Journal of Pathology
2013;47(2):137-147
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH), EBV-positive systemic T-cell lymphoproliferative disease (STLPD) of childhood, and chronic active EBV (CAEBV) infection may develop after primary EBV infection. This study reviewed the clinicopathological spectrum of EBV-associated T- and natural killer (NK)-cell LPD, including STLPD and CAEBV infection, with an analysis of T-cell clonality. METHODS: Clinicopathological features of seven patients with EBV-associated HLH or STLPD and 12 patients with CAEBV infection were reviewed. Immunohistochemical staining and a T-cell receptor (TCR) gene rearrangement study were performed. RESULTS: STLPD and EBV-positive HLH showed significantly overlapping clinicopathological findings. One patient with STLPD and one patient with EBV-positive HLH demonstrated moderate to severe atypia of the infiltrating lymphocytes, whereas the remaining patients lacked significant atypia. Twelve patients had CAEBV infection, four of whom suffered mosquito-bite hypersensitivity, five showed NK lymphocytosis, and one suffered hydroa vacciniforme. Infiltrating lymphocytes were predominantly small and devoid of atypia. Hemophagocytic histiocytosis was found in seven of 11 patients. Monoclonality was detected in three (50%) of the six patients with successful TCR gene analysis. CONCLUSIONS: EBV-positive HLH and STLPD share similar clinicopathological findings and may constitute a continuous spectrum of acute EBV-associated T- or NK-cell proliferative disorders. The distinction of EBV-positive T-cell LPD from EBV-positive HLH may be difficult during routine diagnoses because of the technical limitations of clonality assessment.
