Epstein-Barr virus-positive follicular lymphoma

Nicholas Mackrides, German Campuzano-Zuluaga, Yvan Maque-Acosta, Adrienne Moul, Nouf Hijazi, Offiong Ikpatt, Ronald Levy, Ramiro E Verdun, Kranthi Kunkalla, Yasodha Natkunam, Izidore Lossos, Francisco Vega, Jennifer Chapman-Fredricks

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Abstract

Epstein-Barr virus (EBV) -associated follicular lymphoma is only rarely reported. Herein, we report the largest series analyzing prevalence and clinicopathologic characteristics of EBV-associated follicular lymphoma occurring in unselected cases. Out of 382 analyzed cases, 10 EBV-positive follicular lymphomas were identified (prevalence=2.6%, 95% confidence interval 1.3-4.0%). All EBV-positive follicular lymphomas showed EBV-encoded small RNA-positive lymphoma cells present in a follicular distribution. Of these, eight also had tissue available for testing of expression of latent membrane protein 1 (LMP1), out of which six (75%) were positive. There was a significant association with grades 3A-3B follicular lymphoma (P<0.0001) and CD30 expression (P=0.0002). EBV-positive follicular lymphomas were otherwise morphologically and immunophenotypically indistinguishable from EBV-negative cases of similar grade. Nine of the EBV-positive follicular lymphomas occurred in patients with no known history of immunosuppression, while one patient had a history of hydroxychloroquine administration for Sjögren's syndrome. The mean age in the EBV-positive and -negative follicular lymphomas was 56 (range 31-83 years) and 49 years (range 25-92 years), respectively, with no statistically significant difference. Seven of the patients with EBV-positive follicular lymphoma had additional biopsies from different time points available for review, all of which showed progression of disease in the form of progression of tumor grade. Five of these progressed to diffuse large B-cell lymphoma, one of which had tissue available for testing and was EBV-positive. Our findings suggest that EBV infection may have a role in lymphomagenesis and/or disease progression in a subset of follicular lymphomas, thereby expanding the spectrum of recognized EBV-associated B-cell lymphomas.

Original languageEnglish (US)
Pages (from-to)519-529
Number of pages11
JournalModern Pathology
Volume30
Issue number4
DOIs
StatePublished - Apr 1 2017

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Follicular Lymphoma
Human Herpesvirus 4
Disease Progression
Hydroxychloroquine
Epstein-Barr Virus Infections
Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
Immunosuppression
Lymphoma
Membrane Proteins

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Mackrides, N., Campuzano-Zuluaga, G., Maque-Acosta, Y., Moul, A., Hijazi, N., Ikpatt, O., ... Chapman-Fredricks, J. (2017). Epstein-Barr virus-positive follicular lymphoma. Modern Pathology, 30(4), 519-529. https://doi.org/10.1038/modpathol.2016.214

Epstein-Barr virus-positive follicular lymphoma. / Mackrides, Nicholas; Campuzano-Zuluaga, German; Maque-Acosta, Yvan; Moul, Adrienne; Hijazi, Nouf; Ikpatt, Offiong; Levy, Ronald; Verdun, Ramiro E; Kunkalla, Kranthi; Natkunam, Yasodha; Lossos, Izidore; Vega, Francisco; Chapman-Fredricks, Jennifer.

In: Modern Pathology, Vol. 30, No. 4, 01.04.2017, p. 519-529.

Research output: Contribution to journalArticle

Mackrides, N, Campuzano-Zuluaga, G, Maque-Acosta, Y, Moul, A, Hijazi, N, Ikpatt, O, Levy, R, Verdun, RE, Kunkalla, K, Natkunam, Y, Lossos, I, Vega, F & Chapman-Fredricks, J 2017, 'Epstein-Barr virus-positive follicular lymphoma', Modern Pathology, vol. 30, no. 4, pp. 519-529. https://doi.org/10.1038/modpathol.2016.214
Mackrides N, Campuzano-Zuluaga G, Maque-Acosta Y, Moul A, Hijazi N, Ikpatt O et al. Epstein-Barr virus-positive follicular lymphoma. Modern Pathology. 2017 Apr 1;30(4):519-529. https://doi.org/10.1038/modpathol.2016.214
Mackrides, Nicholas ; Campuzano-Zuluaga, German ; Maque-Acosta, Yvan ; Moul, Adrienne ; Hijazi, Nouf ; Ikpatt, Offiong ; Levy, Ronald ; Verdun, Ramiro E ; Kunkalla, Kranthi ; Natkunam, Yasodha ; Lossos, Izidore ; Vega, Francisco ; Chapman-Fredricks, Jennifer. / Epstein-Barr virus-positive follicular lymphoma. In: Modern Pathology. 2017 ; Vol. 30, No. 4. pp. 519-529.
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