Abstract
In classic Hodgkin lymphoma (cHL), Epstein Barr virus (EBV) association varies worldwide.Aims: Our aim was to analyze EBV association with pediatric cHL for the last 28 years.Methods: EBV presence was evaluated by EBERs in situ hybridization and LMP1 immunohistochemistry.Results: Until 2008, we found in pediatric cHL a similar percentage of EBV presence to those observed in adult cHL from developed populations. Nevertheless, in the last 8 years, an unexpected difference in cHL EBV association was proven, along with a slight bias of EBV association with the nodular sclerosis (NS) subtype. Concerning histological subtype distribution, even though MC still prevailed in the whole series, those cases diagnosed as NS showed a sustained rise from 1989 until today.Conclusion: Variations of EBV association of cHL related to geography, age, ethnicity, and histological type have been largely described when compared with different world regions, but interestingly, this single-center revised series brought to light the dynamic process behind the evolution of this relationship over time.
Highlights
Epstein Barr virus (EBV) is related to more than 200,000 cases of cancer every year; 1.8% of all cancer deaths are caused by EBV-related neoplasias[1]
The three major types of B cell malignancies associated to EBV are Burkitt, classic Hodgkin, and diffuse large B cell lymphomas (BL, cHL, and DLBCL), in which EBV presence varies from 10 to 100% of cases in BL, ∼50% in cHL, and ∼10% in DLBCL
EBV association with cHL was observed in 103/174 patients (59%) by EBERs in situ hybridization (ISH) and LMP1 expression
Summary
Epstein Barr virus (EBV) is related to more than 200,000 cases of cancer every year; 1.8% of all cancer deaths are caused by EBV-related neoplasias[1]. The three major types of B cell malignancies associated to EBV are Burkitt, classic Hodgkin, and diffuse large B cell lymphomas (BL, cHL, and DLBCL), in which EBV presence varies from 10 to 100% of cases in BL, ∼50% in cHL, and ∼10% in DLBCL. EBV is associated in 100% of cases with T/NK lymphoproliferations and nasopharyngeal carcinoma, as well as in ∼10% in gastric carcinoma (1). CHL is subclassified into nodular sclerosis (NS), mixed cellularity (MC), lymphocyte-rich (LRHL), and lymphocyte-depleted (LDHL) (3). CHL includes three different disease entities: pediatric HL
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