Detection of occult low-grade B-cell non-hodgkin's lymphoma in patients with chronic hepatitis C infection and mixed cryoglobulinemia

Rasul, Imran; Shepherd, Frances A.; Kamel‐Reid, Suzanne; Krajden, Mel; Pantalony, Dominic; Heathcote, E. Jenny

doi:10.1002/hep.510290224

Cited by 89 publications

(41 citation statements)

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“…Five of these cases had grade II and two had grade III MALT lymphoma. This result suggests that HCV may permit the development of acquired MALT [40]. In another study, flow cytometry of bone marrow aspirates was used to study 16 cases having chronic HCV infection with clinically active mixed cryoglobulinemia, and NHL was detected in 2 cases [41].…”

Section: Discussionmentioning

confidence: 99%

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Detection of hepatitis C virus RNA in paraffin‐embedded tissues from patients with non‐Hodgkin's lymphoma

et al. 2004

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The aim of this study is to detect the possible role of hepatitis C Virus (HCV) in lymphomagenesis. HCV‐RNA and anti‐HCV antibodies were studied in tissue and serum samples taken from patients with non‐Hodgkin's Lymphoma (NHL). The prevalence of HCV, the clinical presentation of these cases, and association with histologic subtypes were determined. RT‐PCR was used to detect the HCV‐RNA in serum and tissue samples. The anti‐HCV antibodies were tested with microparticle enzyme immunoassay. Immunohistochemistry with the ABC method was used to detect the HCV core protein in HCV‐RNA+ cases. RNA could be detected in 30 of 35 cases, and other tests were performed in these 30 samples. HCV‐RNA was detected in 11 tissue samples (11/30, 37%). HCV core protein was studied in 10 of 11 HCV‐RNA+ cases, and 1–3% nuclear staining was found in only 2 samples. Serologically, HCV‐RNA was detected in 7 of 30 samples (23.3%) and anti‐HCV antibody was detected in 3 of 30 samples (10%). Detection of HCV‐RNA in 37% of the lymphoma tissue samples suggests that HCV may have a role or is a contributing factor in the pathogenesis of lymphoma. The very low HCV core protein in lymphoma tissues may be due to the low viral load in lymphoid tissues and/or higher sensitivity of the PCR method. Detection of anti‐HCV antibody in only three cases may be associated with undetectable levels of antibodies due to the immune deficiency in cases with NHL. Am. J. Hematol. 76:252–257, 2004. © 2004 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

“…Infection of peripheral blood mononuclear cells with HCV is a useful parameter in the pathogenesis of HCV infection [40]. Although some investigators believe HCV plays a role in the pathogenesis of NHL, some others refuse this explanation [8,9,25,26,30,[43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Detection of hepatitis C virus RNA in paraffin‐embedded tissues from patients with non‐Hodgkin's lymphoma

et al. 2004

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“…61 Persistence or relapse of CV even after clearance of HCV infection should make one suspect and rule out B cell malignancy as B cell lymphomas have been reported in such cases. 62 Most anti-inflammatory drugs used for management of other vasculitides like cyclophosphamide have been used for management of CV. However, it has been shown that immunosuppressive treatment has been associated with increased mortality independent of disease activity.…”

Section: Management Of Mixed Cryoglobulinemiamentioning

confidence: 99%

Hepatotropic Viral Infection Associated Systemic Vasculitides—Hepatitis B Virus Associated Polyarteritis Nodosa and Hepatitis C Virus Associated Cryoglobulinemic Vasculitis

Sharma

2013

Journal of Clinical and Experimental Hepatology

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Two hepatotropic viruses have been shown to have causal relationship with systemic vasculitis-hepatitis B with classical polyarteritis nodosa and hepatitis C with cryoglobulinemic vasculitis. The present paper provides an updated overview on the clinical presentations and management of these vasculitides.HBV associated PAN patients have higher weight loss, peripheral neuropathy, mononeuritis multiplex, abdominal pain, gastrointestinal manifestations requiring surgery, cardiomyopathy, orchitis, hypertension, and/or elevated transaminase levels. Microaneurysms are also more common in mesenteric artery. Skin manifestations, however are less common. These patients also have a severe disease as suggested by higher five factor score and higher BVAS. Though relapses are less common, mortality is higher in patients with HBV PAN as compared to non HBV PAN. Plasmapheresis has a role in treatment in clearing off immune complexes.The common clinical manifestations of HCV associated cryoglobulinemic vasculitis are skin lesions, peripheral neuropathy, glomerulonephritis, arthritis, and sicca symptoms. Though combination therapy comprising of pegylated interferon a and ribavirin is the first line of management, immunotherapy is needed for severe or life threatening manifestations. Recent randomized trials have shown the efficacy of rituximab in such situations. ( J CLIN EXP HEPATOL 2013;3:204-212)

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“…5 Mixed cryoglobulinemia is considered by some investigators to be a variant of lowgrade, B-cell non-Hodgkin's lymphoma. 6,7 This has prompted several groups to investigate the association between HCV infection and overt B-cell malignancies. Evidence suggesting a direct relationship between HCV infection and development of these tumors have been reported in several Italian studies and in one American study, which demonstrates a high prevalence of chronic HCV infection, 9% to 42%, in patients with B-cell lymphoma.…”

Section: H Epatitis C Virus (Hcv) Is a Hepatotropic Virus;mentioning

confidence: 99%

Primary lymphoma of the liver: Clinical-pathological features and relationship with HCV infection in French patients

et al. 2003

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Primary lymphoma of the liver (PLL) is rare. In some cases, the hepatic lymphoma has been diagnosed in patients who were infected by the hepatitis C virus (HCV). It has been suggested that HCV plays a role in the pathogenesis of lymphoma. The aim of our multicentric retrospective study was to assess the characteristics of PLL and to determine the prevalence of HCV infection in PLL. Thirty-one immunocompetent patients (anti-human immunodeficiency virus, anti-human T-cell leukemia/lymphoma virus negative, no history of allograft) with PLL fulfilled the entire selection criteria. The liver biopsy specimens were reassessed by the same pathologist. The non-Hodgkin's lymphomas were classified according to the World Health Organization classification. Blood samples were tested in 28 patients for antibodies to HCV, and HCV RNA was detected by reverse transcription polymerase chain reaction. In the majority of cases, the clinical, biologic, and radiologic data were nonspecific. Twentyseven of 31 patients presented a B-cell lymphoma corresponding to the centroblastic morphologic variant of a diffuse, large B-cell lymphoma (22 cases), a Burkitt's lymphoma (1 case), an extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (3 cases), and unclassified, small B-cell lymphoma (1 case). The 4 other cases were T-cell lymphomas. The prevalence of HCV infection was 21% (6 of 28 cases). All of these patients were positive for HCV RNA by polymerase chain reaction in blood. Most of the HCVinfected patients presented a high-grade, B-cell type lymphoma. In conclusion, our study confirms the rarity of PLL and demonstrates an increased prevalence of HCV infection. H epatitis C virus (HCV) is a hepatotropic virus;however, the HCV genome and its replicative intermediate have been detected in peripheral blood mononuclear cells in patients with chronic HCV infection. 1,2 There is a strong association between HCV and type II mixed cryoglobulinemia. [3][4][5] Antibodies to HCV and HCV RNA have been found in up to 98% of patients with mixed cryoglobulinemia, 3 and approximately 36% of patients with chronic HCV infection have mixed cryoglobulinemia. 5 Mixed cryoglobulinemia is considered by some investigators to be a variant of lowgrade, B-cell non-Hodgkin's lymphoma. 6,7 This has prompted several groups to investigate the association between HCV infection and overt B-cell malignancies. Evidence suggesting a direct relationship between HCV infection and development of these tumors have been reported in several Italian studies and in one American study, which demonstrates a high prevalence of chronic HCV infection, 9% to 42%, in patients with B-cell lymphoma. [8][9][10][11] However, data from other countries have not confirmed these findings. [12][13][14][15] Primary lymphoma of the liver (PLL) is rare, with less than 150 cases reported. 16,17 In some cases, the hepatic lymphoma was diagnosed in From the

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Detection of occult low-grade B-cell non-hodgkin's lymphoma in patients with chronic hepatitis C infection and mixed cryoglobulinemia

Cited by 89 publications

References 14 publications

Detection of hepatitis C virus RNA in paraffin‐embedded tissues from patients with non‐Hodgkin's lymphoma

Detection of hepatitis C virus RNA in paraffin‐embedded tissues from patients with non‐Hodgkin's lymphoma

Hepatotropic Viral Infection Associated Systemic Vasculitides—Hepatitis B Virus Associated Polyarteritis Nodosa and Hepatitis C Virus Associated Cryoglobulinemic Vasculitis

Primary lymphoma of the liver: Clinical-pathological features and relationship with HCV infection in French patients

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