Clinicopathological analysis of elderly Epstein-Barr virus-positive diffuse large B-cell lymphoma of Han and Uygur in Xinjiang Uygur Autonomous Region

Abstract

Objective To analysis the clinical features of elderly diffuse large B-cell lymphoma (DLBCL) patients with Epstein-Barr virus (EBV) infection and their prognostic factors. Methods 250 cases of DLBCL were retrospectively studied by in situ hybridization (ISH) to detect the EBV and by immunohistochemical to evaluate the histological type and Ki-67 protein. Results 36 cases with EBV positive included 28 elderly (aged ≥ 60 years), of which 21 cases were Han, 15 cases were Uygur, male/female ratio was 2∶1. There were 23 cases with nodal presentation only, 13 cases with extra-nodal presentation. Twenty-nine patients presented with advanced disease (Ann Arbor stage Ⅲ/Ⅳ), 30 patients were found with high lactate dehydrogenase (LDH), 22 patients with high IPI score (3-5). Histological observation showed a diffuse and polymorphic proliferation of large lymphoid cells with varying degrees of reactive components. These tumor cells were frequently characterized by a broad range of B-cell maturation, containing centroblasts, immunoblasts, and Hodgkin-and Reed-Stemberg (HRS)-like giant cells. Immunohistochemical studies showed that tumor cells were positive for CD20 and (or) CD79a in almost cases, most of the cases had a high proliferative index. CD10, bcl-6, Mum-1 performed histological type, 31 cases were non-germinal center. Except the age and location (P 0.05). Conclusion The incidence of elderly EBV+ DLBCL is low, it has some unique clinical and pathological features with poor prognosis. Key words: Herpesvirus 4, human; Elderly; Lymphoma, B-cell; In situ hybridization; Differential diagnosis