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人类免疫缺陷病毒(HIV)与爱泼斯坦-巴尔病毒(EBV)相关淋巴瘤,病理学视角

Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) related lymphomas, pathology view point.

作者信息

Linke-Serinsöz Ebru, Fend Falko, Quintanilla-Martinez Leticia

机构信息

Institute of Pathology, University Hospital Tübingen, Eberhard-Karls-University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany.

Institute of Pathology, University Hospital Tübingen, Eberhard-Karls-University of Tübingen and Comprehensive Cancer Center, Tübingen, Germany.

出版信息

Semin Diagn Pathol. 2017 Jul;34(4):352-363. doi: 10.1053/j.semdp.2017.04.003. Epub 2017 Apr 7.

Abstract

The contribution of Epstein Barr virus (EBV) and Kaposi sarcoma herpes virus (KSHV) to the development of specific types of malignant lymphomas occurring in the human immunodeficiency virus (HIV) setting has been extensively studied since the beginning of the HIV epidemic 35 years ago. The introduction of highly active antiretroviral therapies (HAART) in 1996 has changed dramatically the incidence of HIV-related malignancies. Nevertheless, malignant lymphomas continue to be the major group of malignances observed in HIV infected individuals, and the most common cause of cancer related-deaths. Common features of the predominant B-cell lymphomas in the HIV setting are the frequent plasmacytoid morphology of the neoplastic cells, advanced stage, aggressive disease and frequent extranodal involvement. In this article, we review the evolving concepts and definitions of the various EBV-associated lymphomas in HIV patients, including diffuse large B-cell lymphoma, Burkitt lymphoma, classical Hodgkin lymphoma, plasmablastic lymphoma and primary effusion lymphoma. The current knowledge regarding the pathogenesis of these malignancies, the interplay between HIV and EBV co-infection in the development of certain HIV related lymphomas, and the emerging paradigm that suggests that HIV may play a direct role in lymphomagenesis are explored as well.

摘要

自35年前艾滋病流行伊始,爱泼斯坦-巴尔病毒(EBV)和卡波西肉瘤疱疹病毒(KSHV)在人类免疫缺陷病毒(HIV)感染情况下导致特定类型恶性淋巴瘤发生中的作用就已得到广泛研究。1996年高效抗逆转录病毒疗法(HAART)的引入极大地改变了HIV相关恶性肿瘤的发病率。然而,恶性淋巴瘤仍是HIV感染者中观察到的主要恶性肿瘤类别,也是癌症相关死亡的最常见原因。HIV感染情况下主要B细胞淋巴瘤的共同特征是肿瘤细胞频繁出现浆细胞样形态、晚期、侵袭性疾病以及频繁的结外受累。在本文中,我们回顾了HIV患者中各种EBV相关淋巴瘤不断演变的概念和定义,包括弥漫性大B细胞淋巴瘤、伯基特淋巴瘤、经典霍奇金淋巴瘤、浆母细胞淋巴瘤和原发性渗出性淋巴瘤。还探讨了关于这些恶性肿瘤发病机制的现有知识、HIV与EBV共同感染在某些HIV相关淋巴瘤发生过程中的相互作用,以及表明HIV可能在淋巴瘤发生中起直接作用的新范式。

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