Carbone Antonino, Gloghini Annunziata
Department of Pathology, Istituto Nazionale Tumori, Milan, Italy.
Br J Haematol. 2008 Jan;140(1):13-24. doi: 10.1111/j.1365-2141.2007.06879.x. Epub 2007 Nov 7.
This review looks at the current state of knowledge on primary effusion lymphoma (PEL) and other Kaposi sarcoma herpesvirus (KSHV)/human herpesvirus 8 (HHV8)-associated lymphomas. In 1995, KSHV DNA sequences were identified within a distinct subgroup of acquired immunodeficiency syndrome-related non-Hodgkin lymphomas localized in body cavities and presenting as pleural, peritoneal and pericardial lymphomatous effusions. Subsequently, the spectrum of KSHV/HHV8-associated lymphomas has been expanded by the identification of cases of extracavitary solid lymphomas without serous effusions. Despite the diversification in the clinical presentation of KSHV/HHV8-associated lymphomas, the majority of the cases reported demonstrated similar morphology, immunophenotype and KSHV/HHV8 viral status. KSHV/HHV8 infection is also in multicentric Castleman disease-associated plasmablastic lymphoma. The exact oncogenic mechanisms of KSHV/HHV8 are not clearly defined. The prognosis for KSHV/HHV8-associated lymphomas is poor. Novel approaches for therapy, outside traditional chemotherapy with CHOP (cyclophosphamide, doxorubicin, prednisone, vincristine), have been suggested. These include the addition of antiviral therapy as well as inhibition of specific cellular targets.
本综述探讨了原发性渗出性淋巴瘤(PEL)及其他卡波西肉瘤疱疹病毒(KSHV)/人类疱疹病毒8型(HHV8)相关淋巴瘤的当前知识状况。1995年,在获得性免疫缺陷综合征相关的非霍奇金淋巴瘤的一个独特亚组中鉴定出KSHV DNA序列,这些淋巴瘤局限于体腔,表现为胸腔、腹腔和心包淋巴瘤性渗出液。随后,通过鉴定无浆液性渗出液的腔外实体淋巴瘤病例,KSHV/HHV8相关淋巴瘤的范围得到了扩展。尽管KSHV/HHV8相关淋巴瘤的临床表现有所多样化,但报告的大多数病例显示出相似的形态学、免疫表型和KSHV/HHV8病毒状态。KSHV/HHV8感染也见于多中心Castleman病相关的浆母细胞淋巴瘤。KSHV/HHV8的确切致癌机制尚不清楚。KSHV/HHV8相关淋巴瘤的预后较差。有人提出了传统CHOP(环磷酰胺、阿霉素、泼尼松、长春新碱)化疗之外的新治疗方法。这些方法包括添加抗病毒治疗以及抑制特定的细胞靶点。