OBJECTIVETo investigate the efficiency of concurrent application of VCA-IgA, EA-IgA and EA-IgG serological tests in diagnosing nasopharyngeal carcinoma (NPC).

METHODSThe sera of 266 untreated NPC patients and 347 healthy adults were collected. In addition to the conventional immunoenzymatic method of VCA-IgA test, enzyme-linked immunosorbent assay (ELISA) was adopted as an alternative to test the antibody level of EA-IgG and EA-IgA. A new statistical formula was used to evaluate the odds ratio of different combinations of these three tests.

RESULTSThe sensitivity and specificity of VCA-IgA, EA-IgG and EA-IgA concurrently were as high as 95.11% and 97.41%, respectively, which were higher than those of single test (90.60% and 94.52% for VCA-IgA, 93.98% and 93.66% for EA-IgG, 89.84% and 88.18% for EA-IgA). Furthermore, the odds ratio of 3-test positivity (1 912.5) was higher than those of 2-test positivity (27.903 2 for VCA-IgA and EA-IgG, 11.169 0 for EA-IgG and EA-IgA, 8.032 8 for VCA-IgA and EA-IgA), which were even higher than those of 1-test positivity (0.121 4 for VCA-IgA, 0.170 5 for EA-IgG and 0.048 8 for EA-IgA).

CONCLUSIONELISA is more accurate in reflecting the antibody level of EA-IgG and EA-IgA than the conventional immunoenzymatic method. The concurrent application of VCA-IgA, EA-IgG and EA-IgA test can markedly improve the sensitivity, specificity and odds ratio as well, thus resulting in enhancing the efficiency of diagnosing nasopharyngeal carcinoma serologically.

Adult ; Antibodies, Viral ; blood ; Antigens, Viral ; immunology ; Capsid Proteins ; immunology ; Diagnostic Errors ; Epstein-Barr Virus Infections ; blood ; diagnosis ; immunology ; virology ; Herpesvirus 4, Human ; immunology ; isolation & purification ; Humans ; Immunoglobulin A ; blood ; Nasopharyngeal Neoplasms ; blood ; immunology ; virology ; Sensitivity and Specificity ; Serologic Tests

A CD30+ anaplastic large cell lymphoma (ALCL) cell line was established from the mononuclear cells isolated from pleural effusion of a patient with non-Hodgkin's lymphoma. The cell line's biological characteristics were analyzed. The results showed that the established cell line could survive and proliferate in RPIM 1640 medium; the Wright-Giemsa-stained cells were exactly similar to malignant cells of CD30+ ALCL in morphology, with many diffuse virus granules in cytoplasm; the cytochemical staining of the cells showed the following reactivity pattern: positive for acid phosphatase (ACP) and periodic acid-Schiff (PAS), negative for peroxidase (POX), myeloperoxidase (MPO) and platelet peroxidase (PPO). The immunoprofile of the cells was positive for CD45, HLA-DR, CD30 and negative for EMA, CD34, CD38, CD2, CD3, CD4, CD7, CD8, CD10, CD15, CD19 and CD20. The cytogenetic analysis showed complicate d qualitative and quantitative abnormality of chromosomes, without typical t(2;5). It is concluded that the established cell line is CD30+ anaplastic large cell lymphoma cell line.
Apoptosis ; Cell Line, Tumor ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunophenotyping ; Karyotyping ; Ki-1 Antigen ; analysis ; Lymphoma, Large B-Cell, Diffuse ; genetics ; immunology ; pathology ; Middle Aged

Hypersensitivity to mosquito bites (HMB) is a disorder characterized by a necrotic skin reaction and generalized symptoms subsequent to mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer cell leukemia/lymphoma. We describe here a Korean child who had HMB associated with chronic EBV infection and natural killer cell lymphocytosis. A 5-yr-old boy was suffered from necrotic skin lesions on the right ear lobe. Type A EB virus was detected from hlood cells and bone marrow biospy recognized hemophagocyrosis.
Animals ; Child, Preschool ; Culicidae/*immunology ; Epstein-Barr Virus Infections/complications/*diagnosis ; Herpesvirus 4, Human/genetics/isolation & purification ; Humans ; Hypersensitivity/complications/*diagnosis ; Insect Bites and Stings/complications/*immunology ; Killer Cells, Natural/immunology/*pathology ; Lymphocytosis/complications/*diagnosis ; Male ; Polymerase Chain Reaction

Increasing evidence suggests that multiple genes in the human leukocyte antigen(HLA) regions play an important role in development of cancers and immunity disorders. However, the biological mechanisms of the HLA associations are not well understood. We recently conducted a survey of all genome-wide association studies (GWAS) with significant findings in the HLA regions and concluded that diseases such as cancer and immune disorders are more likely to be associated with genetic variants located in the HLA regions than other diseases. This finding is suggestive for testing a hypothesis of a common etiology of infectious tumors and other immunity diseases.
Genetic Predisposition to Disease ; Genetic Variation ; Genome-Wide Association Study ; HLA Antigens ; genetics ; metabolism ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immune System Diseases ; genetics ; immunology ; virology ; Lymphoma, Non-Hodgkin ; genetics ; immunology ; virology ; Nasopharyngeal Neoplasms ; genetics ; immunology ; virology

BACKGROUNDTo find a rapid and sensitive method for early diagnosis of nasopharyngeal carcinoma by using EBV TK kinase.

METHODSProkaryotic expression plasmid pRSETTK was constructed. EBV TK kinase was highly expressed in E.coil BL21 (DE3). The authors identified specificity of TK kinase by Western blot, then used purified TK kinase in ELISA to detect the IgG antibody in the serum of NPC patients.

RESULTSSpecific IgG antibody against TK kinase was found in the serum of NPC patients. The specificity and sensitivity of TK kinase were both 100% in Western blot and were 98.0% and 93.4% respectively in ELISA.

CONCLUSIONSThe EBV TK kinase showed high specificity and sensitivity in ELISA, therefore it can be used for early diagnosis of NPC

Antibodies, Viral ; blood ; Enzyme-Linked Immunosorbent Assay ; methods ; Herpesvirus 4, Human ; enzymology ; Humans ; Immunoglobulin G ; blood ; Nasopharyngeal Neoplasms ; diagnosis ; Recombinant Proteins ; biosynthesis ; immunology ; isolation & purification ; Sensitivity and Specificity ; Thymidine Kinase ; biosynthesis ; isolation & purification

OBJECTIVETo study the clinicopathologic features of intravascular large B-cell lymphoma (IVLBCL).

METHODSTwo autopsy cases of IVLBCL were retrieved from the archival file. The clinicopathologic features, immunohistochemistry and molecular findings were studied.

RESULTSThe deceased were 70-year-old and 50-year-old males. Both of them had complained of a sudden onset of weakness and numbness of lower extremities. The clinical course deteriorated rapidly, with multi-organ failure. They died 85 days and 44 days after the presentation, respectively. Post-mortem examination did not reveal any mass lesion, except the presence of multiple skin and epicardium nodules, ranging from 0.5 cm to 2.5 cm in diameter, in the first patient. Pericardial effusion, ascites and pleural effusion were also observed. Histologically, neoplastic lymphoid cells filled up the small vessel lumina in many organs, including brain, hypophysis, spinal cord, spinal nerve roots, heart, lungs, kidneys, liver, spleen, digestive tract, pancreas, adrenal, thyroid, testes and lymph nodes. The tumor cells were relatively monotonous and of medium to large in size with round vesicular nuclei and 1 to 3 small basophilic nucleoli. Immunohistochemical study showed that the lymphoma cells expressed B-cell markers CD20 and CD79a, occasionally positive for CD5 and bcl-2 but negative for CD3, bcl-6, CD10, CD30, myeloperoxidase and cytokeratin. In-situ hybridization for Epstein-Barr virus-encoded RNA was negative. The proliferative index, as demonstrated by Ki-67 staining, was about 80%. Molecular study showed the presence of immunoglobulin heavy chain gene rearrangement in both cases, T-cell receptor-gamma gene rearrangement was not found.

CONCLUSIONSIVLBCL may present as neurological disturbance and carries distinctive morphologic characteristics, immunophenotype and molecular findings. The prognosis of this disease is often dismal.

Aged ; Antigens, CD20 ; analysis ; Autopsy ; B-Lymphocytes ; pathology ; virology ; CD79 Antigens ; analysis ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell ; immunology ; pathology ; virology ; Lymphoma, Large B-Cell, Diffuse ; immunology ; pathology ; virology ; Male

OBJECTIVETo explore the relationship of Epstein-Barr virus (EBV) specific antibodies detection and the diagnoses of infectious mononucleosis (IM) caused by EBV.

METHODSSingle serum samples were collected from 220 inpatients with the diagnosis of IM between January 2005 and December 2006 in Beijing Children's hospital. The samples were detected for EBV-CA-IgM, EBV-CA-IgG, EBV-EA-IgG, EBV-NA-IgG and the avidity of EBV-CA-IgG by indirect immunofluorescent assay.

RESULTSThe positive rate of EBV-CA-IgG, EBV-CA-IgM, EBV-EA-IgG and EBV-NA-IgG were 100%, 95.9%, 79.5% and 4.1% respectively. Low-avidity EBV-CA-IgG was detected in 204 patients (92.7%) with positive EBV-CA-IgM and EBV-CA-IgG,negative EBV-NA-IgG, low-avidity EBV-CA-IgG were the main pattern of EBV antibody in IM patients (84.6%).

CONCLUSIONThe existence of EBV specific antibody (CA-IgG, CA-IgM, EA-IgG, NA-IgG and avidity of CA-IgG) could add more information to identify the stage of EBV infection so as to provide more reliable serological evidence for the diagnosis of IM.

Adolescent ; Antibodies, Viral ; blood ; Antibody Affinity ; Child ; Child, Preschool ; Epstein-Barr Virus Infections ; diagnosis ; immunology ; Female ; Fluorescent Antibody Technique, Indirect ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunoglobulin G ; blood ; Infant ; Infectious Mononucleosis ; diagnosis ; immunology ; virology ; Male

OBJECTIVETo study the NK/T-cell lymphoma, search for a more efficacious and simpler method and establish a standard guideline for distinguishing the NK-like T-cell lymphoma from the NK-cell lymphoma.

METHODSThirty-four NK or T-cell lymphomas from the upper aerodigestive tract (n = 22), skin (n = 2), gastrointestinal (GI) tract (n = 2), lymph nodes (n = 7), and other sites (n = 1) were studied. Immunophenotype was analyzed by immunohistochemistry. In situ hybridization with EBER 1/2 RNA probes was performed. T-cell receptor (TCR)-beta and -gamma gene rearrangement was analyzed by polymerase chain reaction (PCR).

RESULTSEighteen cases were positive for CD(56) and 16 for TIA-1 in 34 lymphomas cases. All tumor cells in the skin cases were positive for Ki-67. Epstein-Barr virus (EBV) mRNA was detected in 12 upper aerodigestive tumors including 9 of 12 nasal and 3 extranasal tumors. EBER was also detected in 1 of 2 skin lymphomas and both of the 2 GI lymphomas. Clonal TCR-beta and -gamma gene rearrangement was detected in 2 of 22 upper aerodigestive, all of the skin and GI lymphomas, and 6 of 9 nodal and other site lymphomas.

CONCLUSIONMost upper aerodigestive NK/T-cell lymphomas are genotypically NK derivation, and a few belong to T lineage. However, NK-like T-cell lymphomas more frequently seen in skin and GI tract. Nodal NK-cell lymphoma are quite rare. These two kinds of lymphomas can only be diagnosed with additional immunohistochemical markers, EBER detection by ISH, TCR gene rearrangement or NK-cell receptors (NKRs) RNA detection. Detection of TCR rearrangement remains the important standard for the diagnosis of T-cell lymphoma.

Adolescent ; Adult ; Aged ; Child ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunophenotyping ; Killer Cells, Natural ; pathology ; Lymphoma, T-Cell ; genetics ; immunology ; pathology ; Male ; Middle Aged

OBJECTIVETo study the clinicopathologic features of inflammatory pseudotumor-like follicular dendritic cell tumor of spleen.

METHODSOne case of inflammatory pseudotumor-like follicular dendritic cell tumor of spleen was examined macroscopically and microscopically. Immunohistochemical study for CD21, CD23, CD35, clusterin, S-100 protein, vimentin, smooth muscle actin, CD1a, CD68, ALK protein, CD30, CD31, CD34, CD3 and CD20 was performed on formalin-fixed, paraffin-embedded sections by standard EnVision method. In-situ hybridization for Epstein-Barr virus (EBV)-encoded RNA was also carried out.

RESULTSMacroscopically, inflammatory pseudotumor-like follicular dendritic cell tumor was large in size, tan-colored, soft to rubbery in consistance and associated with central hemorrhage and necrosis. Histological examination showed scattered follicular dendritic cells admixed with abundant lymphocytes and plasma cells in the background, simulating inflammatory pseudotumor. On high-power magnification, the follicular dendritic cells possessed a moderate amount of pale to lightly eosinophilic cytoplasm, with indistinct cell borders. The nuclei were ovoid or spindly, with vesicular or stippled chromatin and small distinct, often centrally located, nucleoli. Some of the tumor cells showed nuclear pleomorphism and contained irregular foldings of nuclear membrane, coarse chromatin and prominent eosinophilic nucleoli. Mitotic figures were rarely identified. Immunohistochemical study showed that the tumor cells were positive for vimentin, clusterin, smooth muscle actin and CD68. They were weakly and focally positive for CD35 and S-100 protein, but negative for CD21, CD23, CD1a, ALK protein, CD30, CD31 and CD34. Most of the background lymphocytes were of T-lineage (CD3-positive) ,some were CD20 (B-cell marker)-positive. EBV RNA was demonstrated in the tumor cells by in-situ hybridization analysis.

CONCLUSIONSInflammatory pseudotumor-like follicular dendritic cell tumor is a rarely encountered low-grade malignancy with distinctive morphologic pattern. It is associated with EBV infection.

Adult ; Antigens, CD ; Antigens, Differentiation, Myelomonocytic ; Dendritic Cell Sarcoma, Follicular ; pathology ; physiopathology ; Dendritic Cells, Follicular ; pathology ; Female ; Granuloma, Plasma Cell ; etiology ; Herpesvirus 4, Human ; genetics ; immunology ; isolation & purification ; Humans ; Splenic Neoplasms ; pathology ; physiopathology

OBJECTIVETo improve the clinical diagnostic standard and explore the mechanism of multiple clinical manifestation of Epstein-Barr virus (EBV) infection by studying the primary symptom and related disease spectrum in EBV infected children.

METHODSThe primary symptom, disease spectrum and prognosis of 190 EBV infected children whose serum EBV-VCA-IgM was positive detected by enzyme-linked immunosorbent assay (ELISA) were retrospectively reviewed.

RESULTSThe primary symptoms of EBV infection were diverse, the most common primary symptom was fever (66.8%), and followed by cough (14.2%), skin eruption (7.9%), lymphadenopathy (5.3%), eyelid edema (3.2%), pharyngalgia (1.6%), cardiac arrhythmia (1.6%), convulsion (1.6%), arthralgia (1.0%), gross hematuria (0.5%), etc. Most systems and organs were involved in the disease, including liver, spleen, lymph nodes, kidney, heart, lung, bone marrow, brain etc., which made the disease spectrum diverse. The most common disease caused by EBV infection was respiratory tract infection (40.5%), followed by infectious mononucleosis (17.9%), Kawasaki disease (6.3%), idiopathic thrombocytopenic purpura (5.8%), viral myocarditis (2.6%), viral encephalitis (2.6%), hemophagocytic syndrome (1.6%), rheumatoid arthritis (1.0%), acute lymphadenitis (1.0%), facial neuritis (1.0%), Evans syndrome (0.5%), systemic lupus erythematosus (0.5%), subacute necrotizing lymphadenitis (0.5%), non-Hodgkin's lymphoma (0.5%), acute aplastic anemia (0.5%), infantile hepatitis syndrome (0.5%), etc.; 9.5% of patients were ultimately diagnosed as EBV infection after long-term fever, and 10% of patients suffered from mixed infection. The prognosis of EBV infection was different due to involvement of different systems and organs. One patient died of hemophagocytic syndrome.

CONCLUSIONThe systems and organs impaired by EBV infection in children were diverse, and almost all the systems and organs were involved. Pediatricians should comprehensively analyze the clinical data and order corresponding laboratory examinations early to make the correct diagnosis and reduce the misdiagnosis rate and to treat appropriately.

Adolescent ; Age Factors ; Antibodies, Viral ; blood ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Epstein-Barr Virus Infections ; diagnosis ; pathology ; therapy ; Female ; Herpesvirus 4, Human ; immunology ; isolation & purification ; Humans ; Infant ; Infant, Newborn ; Male ; Prognosis ; Retrospective Studies ; Treatment Outcome