Shimoyama Yoshie, Oyama Takashi, Asano Naoko, Oshiro Aya, Suzuki Ritsuro, Kagami Yoshitoyo, Morishima Yasuo, Nakamura Shigeo
Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan.
J Clin Exp Hematop. 2006 Mar;46(1):1-4. doi: 10.3960/jslrt.46.1.
Epstein-Barr virus (EBV) is associated with a number of malignant lymphomas, including Burkitt lymphomas, Hodgkin lymphomas (HLS), immunodeficiency-associated lymphoproliferative disorders (LPDs), and subset of diffuse large B-cell lymphomas. We have recently identified a series of elderly patients afflicted with EBV-associated (EBV-positive) B-cell LPDs in the absence of predisposing immunodeficiencies ; we have named these neoplasms "senile" EBV+ B-cell LPDs. The large series of patients with this disease (n=76) provided additional evidence that this neoplasia, with a median age of onset of 71 years, has the highest incidence in elderly patients aged >50 years, suggesting that this disease may be related to the immunological deterioration that occurs during the aging process. These lesions were pathologically characterized by varying numbers of Hodgkin and Reed-Sternberg (HRS)-like giant cells, often posing a diagnostic problem differentiating this condition from HL. Recent studies, however, have indicated that HL and non-Hodgkin lymphoma (NHL) may be more closely related than previously implied, promoting the general consensus that HRS cells are derived from B cells in most HL cases. The relationship between EBV+ HL and EBV+ B-cell LPDs remains to be clarified. This review provides a unique opportunity to highlight the gray areas between EBV+ HL and EBV+ B-cell LPDs. Further investigations are necessary to clarify the interrelationship, including their overlapping morphological and biological features.
爱泼斯坦-巴尔病毒（EBV）与多种恶性淋巴瘤相关，包括伯基特淋巴瘤、霍奇金淋巴瘤（HL）、免疫缺陷相关淋巴增殖性疾病（LPD）以及弥漫性大B细胞淋巴瘤的一个亚组。我们最近发现了一系列老年患者，他们在没有易患免疫缺陷的情况下患有EBV相关（EBV阳性）B细胞LPD；我们将这些肿瘤命名为“老年”EBV+B细胞LPD。大量患有这种疾病的患者（n=76）提供了更多证据，表明这种肿瘤发病年龄中位数为71岁，在年龄大于50岁的老年患者中发病率最高，这表明这种疾病可能与衰老过程中发生的免疫功能衰退有关。这些病变在病理上的特征是有数量不等的霍奇金和里德-斯特恩伯格（HRS）样巨细胞，这常常给将这种情况与HL区分开来带来诊断难题。然而，最近的研究表明，HL与非霍奇金淋巴瘤（NHL）的关系可能比以前认为的更为密切，促使人们普遍达成共识，即在大多数HL病例中，HRS细胞来源于B细胞。EBV阳性HL与EBV阳性B细胞LPD之间的关系仍有待阐明。这篇综述提供了一个独特的机会来突出EBV阳性HL与EBV阳性B细胞LPD之间的灰色地带。需要进一步研究以阐明它们的相互关系，包括它们重叠的形态学和生物学特征。
