EBV positivity in primary cutaneous large B-cell lymphoma with immunophenotypic features of leg type: An isolated incidence or something more significant?

Gaitonde, Sujata; Kavuri, Sravan; Alagiozian-Angelova, Victoria; Worobec, Sophie M.

doi:10.1080/02841860701621241

Cited by 11 publications

(5 citation statements)

References 15 publications

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“…This study showed that none of the patients were positive for EBV. Although, there are handful of case reports 12,13 suggesting EBV positivity in PCLBCL, interpretation of case reports need to done carefully. Furthermore, it is important to underscore that the role of EBV in DLBCL may be limited.…”

Section: Discussionmentioning

confidence: 96%

Primary Cutaneous Large B-Cell Lymphoma Shows Activation of Nuclear Factor Kappa B and Low Incidence of Epstein-Barr Virus

Bhagavathi¹,

Blenc²,

Amin³

et al. 2010

The American Journal of Dermatopathology

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Primary cutaneous lymphomas are defined as lymphomas, which are present in the skin without evidence of extracutaneous disease at the time of diagnosis. Primary cutaneous large B-cell lymphoma (PCLBCL) is a subtype of primary cutaneous B-cell lymphoma with a female predominance, occurring in elderly patients and known to have unfavorable prognosis. We evaluated 10 cases of PCLBCL in immunocompetent patients between 2005 and 2008. A panel of immunoperoxidase stains; CD3, CD10, CD20, BCL2, BCL6, and MUM1 were performed on all cases. Nuclear factor kappa B (NF-kappaB) pathway activation was evaluated using an immunostain for P65. The presence of Epstein-Barr virus (EBV) was assessed using Epstein-Barr virus encoded RNA (EBER) in situ hybridization probe. All cases were CD20 positive and CD3 negative. CD10, BCL6, BCL2, and MUM1 were positive in 4/10 (40%), 6/10 (60%), 7/10 (70%), and 7/10 (70%) cases, respectively. NF-kappaB activation was detected in 7/10 (70%) cases. One (10%) case was positive for EBV by in situ hybridization. Interestingly, the EBV positive case was also positive for MUM1 and negative for CD10, indicating an activated immunophenotype. In conclusion, majority of PCLBCL shows activation of NF-kappaB pathway with a low incidence of EBV.

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Section: Discussionmentioning

confidence: 96%

Primary Cutaneous Large B-Cell Lymphoma Shows Activation of Nuclear Factor Kappa B and Low Incidence of Epstein-Barr Virus

Bhagavathi¹,

Blenc²,

Amin³

et al. 2010

The American Journal of Dermatopathology

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“…Although, to the best of our knowledge, only one case of EBV-positive PCLBCL, leg type has been reported (22), EBV has been detected in 12-44% of lymphomas in RA patients treated with MTX (7,8,12,13,23). Some patients with RA/MTX-associated lymphoma have been reported to display regression following the discontinuation of MTX, the majority of whom were EBV-positive (7,11,12).…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid Arthritis/Methotrexate-associated Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type

et al. 2014

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This report concerns a 62-year-old man with primary cutaneous diffuse large B-cell lymphoma (PCLBCL), leg type that developed during methotrexate (MTX) treatment for rheumatoid arthritis (RA). Several tumors were observed on the left lower leg. A histological analysis showed diffuse proliferation of large neoplastic B-cells that were immunophenotypically CD10-/MUM1+/BCL6-/BCL2+ and cytogenetically had IgH/c-MYC translocation without translocation involving BCL6 or IgH/BCL2. No evidence of Epstein-Barr virus (EBV) infection was found. The discontinuation of MTX resulted in a 20-month disease-free period. No previous cases of PCLBCL, leg type associated with RA or MTX therapy have been reported. The phenotypes of our patient were partly different from those of typical PCLBCL, leg type or RA/MTX-associated lymphoma.

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“…DLBCL most often occurs in elderly patients as a rapidly growing tumor on the lower extremities (DLBCL-LT),[ 152 153 ] or elsewhere in immunocompromised patients, often in association with genomic EBV integration into the nuclei of neoplastic lymphocytes (DLBCL-not otherwise specified [NOS]). [ 154 155 ] FCL usually affects younger patients, with slow-growing clustered nodules/plaques in the scalp or upper back, often-displaying peripheral erythema [ Figure 2 ]. [ 134 135 140 ]…”

Section: Diagnostic Approach Based On the Predominant Morphologic Andmentioning

confidence: 99%

“…[ 156 157 ] Cases displaying a mixture of morphological or immunophenotypical features of both FCL and DLBCL-LT are currently classified as DLBCL-NOS; in these cases, ISH screening for EBV-encoded RNA may clarify the diagnosis, particularly in elderly or immunocompromised patients. [ 154 155 ]…”

Section: Diagnostic Approach Based On the Predominant Morphologic Andmentioning

confidence: 99%

Approach to cutaneous lymphoid infiltrates: When to consider lymphoma?

2016

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Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a significant challenge since many inflammatory dermatoses can clinically and/or histopathologically mimic cutaneous lymphomas, coined pseudolymphomas. We conducted a literature review from 1966 to July 1, 2015, at PubMed.gov using the search terms: Cutaneous lymphoma, cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia, simulants/mimics/imitators of cutaneous lymphomas, and cutaneous lymphoid infiltrates. The diagnostic approach to CLIs and the most common differential imitators of lymphoma is discussed herein based on six predominant morphologic and immunophenotypic, histopathologic patterns: (1) Superficial dermal T-cell infiltrates (2) superficial and deep dermal perivascular and/or nodular natural killer/T-cell infiltrates (3) pan-dermal diffuse T-cell infiltrates (4) panniculitic T-cell infiltrates (5) small cell predominant B-cell infiltrates, and (6) large-cell predominant B-cell infiltrates. Since no single histopathological feature is sufficient to discern between a benign and a malignant CLI, the overall balance of clinical, histopathological, immunophenotypic, and molecular features should be considered carefully to establish a diagnosis. Despite advances in ancillary studies such as immunohistochemistry and molecular clonality, these studies often display specificity and sensitivity limitations. Therefore, proper clinicopathological correlation still remains the gold standard for the precise diagnosis of CLIs.

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EBV positivity in primary cutaneous large B-cell lymphoma with immunophenotypic features of leg type: An isolated incidence or something more significant?

Cited by 11 publications

References 15 publications

Primary Cutaneous Large B-Cell Lymphoma Shows Activation of Nuclear Factor Kappa B and Low Incidence of Epstein-Barr Virus

Primary Cutaneous Large B-Cell Lymphoma Shows Activation of Nuclear Factor Kappa B and Low Incidence of Epstein-Barr Virus

Rheumatoid Arthritis/Methotrexate-associated Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type

Approach to cutaneous lymphoid infiltrates: When to consider lymphoma?

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