Case Report Epstein-Barr Virus Positive Anaplastic Large Cell Lymphoma: Myth or Reality?
Ly Ma, Youval Katz, Kanu P. Sharan, Roland Schwarting, Annette S. Kim
Department of Pathology, Robert Wood Johnson, Department of Pathology, Cooper University Hospital, Department of Hematology and Oncology, Cooper University Hospital, Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
Received September 15, 2010; accepted December 15, 2010; Epub November 20, 2010; published January 1, 2011
Abstract: The World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissue, 2008 edition, states that anaplastic large cell lymphoma (ALCL) is “consistently negative for Epstein-Barr virus (EBV)”. The statement made by the WHO has led to the widespread belief that EBV can have no pathogenic role in ALCL. Herein we report a case of an immunocompetent 35-year-old male who presented with hemophagocytic syndrome secondary to lymphoma for which diagnostic material consisted solely of a bone marrow biopsy. The biopsy demonstrated large anaplastic cells which were uniformly positive for surface CD3, CD30, CD45, TIA-1 and Granzyme B but negative for ALK-1. In-situ hybridization was strongly positive for EBER in the large neoplastic cells. The uniformity of CD30 expression on the neoplastic cells raises the possibility of an EBV-associated ALCL, ALK-. Discussion of this case as well as a retrospective review of 64 cases of reported of EBV+ ALCL are presented. (IJCEP1009004).
Keywords: Epstein-Barr virus, anaplastic large cell lymphoma, ALK
Address all correspondence to: Annette S. Kim, MD, PhD, Department of Pathology, Vanderbilt University Medical Center, 1301 Medical Center Drive, 4603A TVC Nashville, TN 37232-5310, USA Tel: 615-343-7745 Fax: 615-343-7961 Email: Annette.s.kim@vanderbilt.edu