Hawley Robert C, Cankovic Milena, Zarbo Richard J
Department of Pathology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA.
Arch Pathol Lab Med. 2006 Nov;130(11):1707-11. doi: 10.5858/2006-130-1707-ATLWSE.
Patients with angioimmunoblastic T-cell lymphoma can have profound immune dysfunction and immunodeficiency. Epstein-Barr virus-driven B-cell lymphoid proliferation can occur in angioimmunoblastic T-cell lymphoma, as in other immunodeficiency states. However, few cases of Epstein-Barr virus-positive B-cell lymphoma arising in patients with preexisting angioimmunoblastic T-cell lymphoma have been reported. We report a case of angioimmunoblastic T-cell lymphoma in which diffuse large B-cell lymphoma developed 56 months after the diagnosis of angioimmunoblastic T-cell lymphoma. The patient survived for 9 years after the initial diagnosis of angioimmunoblastic T-cell lymphoma, and molecular studies performed on multiple biopsy specimens during this period revealed the dynamic nature of clonal lymphoid expansion. Epstein-Barr virus latent membrane protein 1 and Epstein-Barr virus-encoded RNA were detected in the diffuse large B-cell lymphoma, suggesting that Epstein-Barr virus may have played a role in the pathogenesis of the diffuse large B-cell lymphoma.
血管免疫母细胞性T细胞淋巴瘤患者可出现严重的免疫功能障碍和免疫缺陷。与其他免疫缺陷状态一样，血管免疫母细胞性T细胞淋巴瘤中可发生爱泼斯坦-巴尔病毒驱动的B细胞淋巴样增殖。然而，既往有血管免疫母细胞性T细胞淋巴瘤的患者发生爱泼斯坦-巴尔病毒阳性B细胞淋巴瘤的病例报道较少。我们报告1例血管免疫母细胞性T细胞淋巴瘤病例，该患者在血管免疫母细胞性T细胞淋巴瘤诊断56个月后发生弥漫性大B细胞淋巴瘤。该患者在血管免疫母细胞性T细胞淋巴瘤初次诊断后存活了9年，在此期间对多个活检标本进行的分子研究揭示了克隆性淋巴样增殖的动态性质。在弥漫性大B细胞淋巴瘤中检测到爱泼斯坦-巴尔病毒潜伏膜蛋白1和爱泼斯坦-巴尔病毒编码的RNA，提示爱泼斯坦-巴尔病毒可能在弥漫性大B细胞淋巴瘤的发病机制中发挥了作用。
