Clinicopathologic study of mantle cell lymphoma with epstein-barr virus infection: A case series and literature review

Abstract

BackgroundMantle cell lymphoma (MCL) with Epstein–Barr virus (EBV) infection is rarely reported. The objective of this study was to analyze the prevalence and clinicopathological features of MCL with EBV infection in the largest series thus far.MethodsAfter screening 138 cases of MCL, we identified eight cases of MCL with EBV infection.ResultsMost of them (7/8) had non-neoplastic bystander cells with positivity for EBV and no expression of latent membrane protein 1 (LMP1) and EBV nuclear antigen 2 (EBNA2). The cases of MCL with EBER positivity did not have abnormal immune function or other lymphomas. Moreover, their histopathological morphology was indicative of classical MCL. Cases of MCL with EBER positivity exhibited statistically significant differences in lactate dehydrogenase, anemia status, and MCL international prognostic index grouping (P=0.008, P=0.02, P=0.001, and P=0.011, respectively). The differences between the two groups in age, sex ratio, clinical manifestations, and immunohistochemical phenotypes were not statistically significant.ConclusionsThe incidence of MCL with EBV infection was low (5.8%). Clinicopathologically, cases of MCL with EBER positivity were similar to their EBV-negative counterparts. Our findings revealed that most cells infected by EBV in MCL are background cells rather than tumor cells. This is inconsistent with data from previous studies, indicating that tumor cells in MCL may not be prone to EBV infection.

EBV‐Positive Pleomorphic Variant Transformation of CD5‐Negative Mantle Cell Lymphoma: A Rare Case Report and Literature Review

“…Although MCL is not usually considered an EBV + lymphoma [ 16 ], EBV can infect MCL in rare cases. Among patients with MCL, the incidence of EBV + MCL is low, with one report reporting an infection rate of 5.8% [ 6 ]. Interestingly, this study found that clinical and pathological findings were comparable between EBV+ and EBV-negative MCL patients.…”

“…The association between EBV and MCL has rarely been reported, with an estimated incidence of approximately 5.8% of reported MCL cases being EBV-positive. EBV + cells in MCL varied in number, and interestingly, most of the EBV + cells are background CD3+ T cells, instead of tumor cells [ 6 ]. Furthermore, the EBV-associated transformation of MCL has rarely been reported [ 7 ], and the role of EBV in MCL transformation remains unclear.…”