Clinicopathologic features of adult EBV-associated B-cell lymphoproliferative disease

被引:2
|
作者
Woerner, Sonja [1 ]
Mueller-Hermelink, Hans-Konrad [2 ]
Voelker, Hans-Ullrich [3 ]
机构
[1] Univ Wurzburg, Dept Pathol, Klinikum Konstanz, Wurzburg, Germany
[2] Univ Wurzburg, Inst Pathol, Wurzburg, Germany
[3] Univ Wurzburg, Dept Pathol, Leopoldina Krankenhaus Schweinfurt, Wurzburg, Germany
关键词
EBV; Lymphoproliferation; B-cell clonality; Outcome; EPSTEIN-BARR-VIRUS; INFECTIOUS-MONONUCLEOSIS; DISORDERS; PROLIFERATIONS; CLONALITY; GAMMA;
D O I
10.1016/j.prp.2017.11.021
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
In the present study, 21 cases of adult/late-onset EBV-associated lymphoproliferative disease (AELPD) with an uncertain malignant potential were investigated with regard to their histomorphology, immunophenotype, clonal rearrangement of the heavy chain (IgH) and T-cell receptor (TCR) genes and clinical course.& para;& para;The cases were histomorphologically reevaluated and assigned to one of three morphological groups: mononucleosis-like, Hodgkin-like, or polymorphous. In addition, cases with or without detectable necrosis were investigated for differences in clinical outcome.& para;& para;Overall survival was highest in the group with Hodgkin-like morphology (4/4 patients), followed by patients with mononucleosis-like phenotype (4/5 patients surviving). Cases with polymorphous morphology showed the poorest survival rates with 7/12 patients dead of disease (58%). 4/6 patients with histologically detectable necrosis died (66%), but only 4/15 patients without necrosis (27%). 11/21 cases with AELPD showed clonal rearrangement for IgH (n = 4), TCR (n = 5) or IgH + TCR (n = 2). 5/11 patients with clonal rearrangement died (45%), and this percentage was similar in all of the three subgroups.& para;& para;In conclusion, the present study shows that polymorphous morphology and detection of necrosis in AELPD are frequently linked to a fatal clinical course, whereas Hodgkin-like morphology seems to be associated with a more favourable prognosis. Clonal rearrangement of IgH or TCR is frequent in AELPD, but prognosis is unpredictable from this feature.
引用
收藏
页码:207 / 212
页数:6
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