Prevalence of mycosis fungoides and its association with EBV and HTLV-1 in Pakistanian patients

Abstract

Mycosis fungoides (MF) is an indolent T cell lymphoma that is distinguished from other lymphomas by its initial appearance on the skin. The histologic diagnosis of MF may be difficult because there is significant overlap in the histologic features of neoplastic T-cell infiltrates and inflammatory dermatoses. This T-cell neoplasm commonly occurs in a mixed, reactive background and can show only a subtle degree of cytologic atypia, rendering histologic diagnosis difficult. In this study MF constituted 0.86% of all non-Hodgkin s lymphoma (NHL) both T and B, as compared to the Western studies which have reported 0.5% prevalence for MF of all NHL. Polymerase chain reaction (PCR) technique was used to assess T-cell clonality in paraffin-embedded skin biopsies clinically and pathologically suspicious for early MF. Out of the 14 cases diagnosed as MF, amplifiable DNA was isolated from 6 cases, which were further studied for T-cell receptor (TcR) beta, gamma, and delta chain gene rearrangements. Clonal product was seen in 4 out of 6 cases for beta, gamma, and delta TcR chain genes. Association for Epstein Barr virus (EBV) was observed in 3 out of 6 cases (50%) of MF. Although these 3 cases were positive for EBV by PCR, but were negative by in-situ hybridization (ISH). No heterogeneity was noted in these 3 cases of MF for BamHI E, K, N, and Z regions of EBV. All six cases were negative for HTLV-1 (tax region) by PCR. It was concluded that the prevalence of MF in Pakistani population is comparable to the Western data, and that EBV association to MF cases was higher than in Western studies.

Concomitant Occurrence of Kimura Disease and Mycosis Fungoides in a Lebanese Woman: Significance and Response to Rituximab

“…20,21 The possibility of a common viral etiology can also be entertained especially that viruses such as human T-cell lymphotropic virus type 1 and Epstein-Barr virus have been sporadically/inconsistently linked to MF and KD. 7,22,23 The differential diagnosis of KD in this case included follicular center cell lymphoma. However, the latter was ruled out based on many reasons.…”

Comparison of seropositivity of human T lymphotropic virus type 1 in mycosis fungoides patients and normal volunteers: A case-control study and review of literature

“…[21] A study in Pakistan concluded that the prevalence of MF in Pakistan population is comparable to the Western data, and that Epstein-Barr virus (EBV) and not HTLV-1 association to MF cases was higher than in Western studies. [22] A large study conducted by Bzarachi et al on 127 patients (85 MF, 28 SS, 5 Sézary cell leukemia, 4 lymphomatoid papulosis and 5 unspecified cutaneous T-cell lymphomas) originating from Europe (France, Spain, UK, Portugal) or from USA (California) for the presence of HTLV-1 infection markers obviously point toward that MF and SS were not associated with HTLV-1 infection. [9] In lymphoproliferative disorders, except adult T-cell leukemia (ATL), [23] the seronegativity for HTLV-1 is common.…”

Infectious Aetiology of Cancer: Developing World Perspective

“…EBV was identified in 3 out of 6 cases (50%) by PCR but all these were negative on ISH (EBER). This discrepancy is most likely caused by low copy number of infected cells in tissue sections not amplified as in PCR based studies (Noorali et al, 2002).…”