Chapter 36 Virus-Associated Lymphoma
AIDS, Acquired immunodeficiency syndrome; BL, Burkitt lymphoma; EBV, Epstein-Barr virus; HIV, human immunodeficiency virus; HL, Hodgkin lymphoma; KSHV, Kaposi sarcoma—associated herpesvirus; NK, natural killer; PCNSL, primary central nervous system lymphoma; PEL, primary effusion lymphoma; PTLD, posttransplantation lymphoproliferative disorder.
Figure 36-1 EXAMPLES OF EPSTEIN-BARR VIRUS (EBV)—RELATED LYMPHOMAS.
Posttransplantation lymphoproliferative disorder (PTLD), polymorphic type, EBV+ occurring in the gastrointestinal tract of a 15-month-old girl following an orthotopic liver transplant (A and B). There was a mildly atypical lymphocytic infiltrate in the duodenal mucosa composed of small lymphocytes, plasma cells, and occasional large cells (A). The infiltrate was EBV+ as demonstrated by in situ hybridization for Epstein-Barr—encoded RNA (EBER) (B). Hodgkin lymphoma, nodular sclerosing type, EBV+ (C and D). The hematoxylin-eosin section shows a portion of a lymph node from a cervical lymph node biopsy of an 8-year-old girl. There are bands of sclerosis forming a cellular nodule, and within the nodule there is a mixed inflammatory infiltrate and scattered large cells with contracted cytoplasm consistent with lacunar cells (C). The immunophenotype of these cells was that of classic Hodgkin lymphoma, and the cells were EBER+ (D). EBV is seen more frequently in mixed cellularity Hodgkin lymphoma but can be seen in 10% to 40% of cases of nodular sclerosing type. It is even more frequent in cases associated with human immunodeficiency virus (HIV) and in resource-poor regions. Burkitt lymphoma, sporadic type, EBV+ (E and F