Kingma D W, Medeiros L J, Barletta J, Raffeld M, Mann R B, Ambinder R F, Jaffe E S
Hematopathology Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Am J Surg Pathol. 1994 Jan;18(1):48-61. doi: 10.1097/00000478-199401000-00005.
Epstein-Barr virus (EBV) was identified in a subset of cases of Hodgkin's disease (HD) and in some non-Hodgkin's lymphomas (NHLs), particularly those associated with immunodeficiency. Because patients with HD have associated immune system defects, we hypothesized that EBV might be involved in NHLs associated with HD. Using fixed paraffin sections and in situ hybridization for EBV EBER1 RNA, we studied 12 cases of composite NHL + HD, two patients with NHL who simultaneously also had HD involving a different site (simultaneous HD and NHL), 14 NHLs arising in patients who previously had HD, and seven NHLs from patients who subsequently developed HD. Epstein-Barr virus was identified most frequently in composite NHL + HD. Five (42%) cases of composite NHL + HD contained EBV in Reed-Sternberg and Hodgkin cells, four of which also had EBV-positive NHLs, diffuse mixed or large-cell type, with 10 to more than 50 EBV-positive cells per x400 microscopic field. These results suggest that in this subset of four cases, both the NHL and HD components may have arisen from the same EBV-infected progenitor cell. We did not find EBV in two cases of simultaneous NHL and HD or in seven NHLs preceding development of HD. We identified EBV in only two of 14 NHLs following HD, one small noncleaved cell lymphoma and one plasmacytoma, both containing more than 50 EBV-positive cells per x400 microscopic field. These results suggest that EBV plays a minimal role in NHLs associated with HD, with the exception of composite NHL + HD. Hodgkin's disease-associated immune defects may be involved in the pathogenesis of a subset of NHLs following HD, but the exact pathogenesis of most NHLs associated with HD remains uncertain. Parallels with the high-grade Burkitt-like lymphomas associated with human immunodeficiency virus infection are noted.
在一部分霍奇金淋巴瘤（HD）病例以及一些非霍奇金淋巴瘤（NHL）中发现了爱泼斯坦-巴尔病毒（EBV），尤其是那些与免疫缺陷相关的非霍奇金淋巴瘤。由于HD患者存在相关免疫系统缺陷，我们推测EBV可能与HD相关的NHL有关。我们使用针对EBV EBER1 RNA的固定石蜡切片和原位杂交技术，研究了12例复合性NHL + HD、2例同时患有不同部位HD的NHL患者（同时性HD和NHL）、14例既往有HD的患者发生的NHL以及7例随后发生HD的患者的NHL。EBV在复合性NHL + HD中最常被发现。5例（42%）复合性NHL + HD的里德-斯腾伯格细胞和霍奇金细胞中含有EBV，其中4例同时还存在EBV阳性的NHL，为弥漫性混合或大细胞型，每400倍显微镜视野中有10至50多个EBV阳性细胞。这些结果表明，在这4例病例中，NHL和HD成分可能均源自同一个EBV感染的祖细胞。我们在2例同时性NHL和HD病例以及7例HD发生前的NHL中未发现EBV。在HD后的14例NHL中，仅在2例中发现了EBV，1例为小无裂细胞淋巴瘤，1例为浆细胞瘤，每400倍显微镜视野中均含有50多个EBV阳性细胞。这些结果表明，除复合性NHL + HD外，EBV在HD相关的NHL中作用极小。HD相关的免疫缺陷可能参与了HD后一部分NHL的发病机制，但大多数HD相关NHL的确切发病机制仍不确定。文中提到了与人类免疫缺陷病毒感染相关的高级别伯基特样淋巴瘤的相似之处。
