Auerbach Aaron, Aguilera Nadine S
Division of Hematopathology, The Joint Pathology Center, 606 Stephen Sitter Lane, Silver Spring, Maryland 20910.
Department of Pathology, University of Virginia, Charlottesville, Virginia.
Semin Diagn Pathol. 2015 Jan;32(1):12-22. doi: 10.1053/j.semdp.2014.12.001. Epub 2015 Feb 7.
Epstein Barr virus (EBV)-related lymphoproliferative processes occur in the head and neck ranging from reactive processes such as infectious mononucleosis to high grade malignant lymphomas. EBV is a ubiquitous herpes virus that infects more than 90% of adults worldwide, and is generally transferred though saliva. Primary infection can occur throughout life. EBV is the first virus linked to malignancies, both epithelial and lymphoid. Both T and B cell lymphomas can be associated with EBV and evidence shows that an individual's response to the acute EBV infection may be critical in the development of subsequent lymphoma. Currently, in situ hybridization for EBER is the most sensitive available test to detect EBV and should be routinely performed in lymphoproliferative lesions of the head and neck. Immunohistochemistry for EBV related proteins, such as LMP1, is much less sensitive than EBER in situ hybridization, but can help determine latency patterns of EBV infection. Although relatively rare, primary EBV-related lymphomas must be considered in the differential of atypical lymphoid proliferations in the head and neck. We present selected EBV-related disorders of the head and neck discussing etiology as well as differential diagnosis.
爱泼斯坦-巴尔病毒（EBV）相关的淋巴增殖性病变发生于头颈部，范围从反应性病变如传染性单核细胞增多症到高级别恶性淋巴瘤。EBV是一种普遍存在的疱疹病毒，全球超过90%的成年人受其感染，通常通过唾液传播。原发性感染可在一生中任何时候发生。EBV是第一种与上皮性和淋巴性恶性肿瘤相关的病毒。T细胞和B细胞淋巴瘤均可与EBV相关，有证据表明个体对急性EBV感染的反应可能对后续淋巴瘤的发生至关重要。目前，EBER原位杂交是检测EBV最敏感的可用检测方法，应在头颈部淋巴增殖性病变中常规进行。EBV相关蛋白（如LMP1）的免疫组化在检测EBV方面比EBER原位杂交敏感性低得多，但可有助于确定EBV感染的潜伏模式。尽管原发性EBV相关淋巴瘤相对罕见，但在头颈部非典型淋巴增殖性病变的鉴别诊断中必须予以考虑。我们介绍一些选定的头颈部EBV相关疾病，讨论其病因及鉴别诊断。
