Epstein-Barr Virus-Positivity in Diffuse Large B-Cell Lymphomas (DLBCLs) of the Elderly Is More Frequently Found in Mexico Compared to a German Population
A Hofscheier, P Adam, T Vela, C Lome- Maldonado, I Bonzheim, F Fend, L Quintanilla- Martinez. University of Tuebingen, Tuebingen, Germany; Instituto Nacional de Cancerologia, Mexico City, Mexico; Instituto Nacional de la Nutricion, Mexico City, Mexico
Background: Epstein-Barr virus (EBV) positive DLBCL of the elderly was included as a provisional entity in the 2008 WHO classification. Most reports of this entity come from Japan and little is known about it in other world regions. Interestingly, EBV-association in lymphomas is more commonly observed in Asia and in Latin American countries. Therefore, the aims of this study were 1) to compare the incidence of EBV associated DLBCL in non-immunosuppressed patients above 50 years in a Mexican and a German population and 2) to analyze the EBV type and the presence of the 30 bp LMP1 deletion.
Design: In this study 296 DLBCL were included, 169 from Germany and 127 from Mexico. Immunohistochemistry was performed in paraffin-embedded tissue with CD20, bcl2, bcl6, CD10, MUM1, and LMP1 antibodies. EBV was detected by EBER in situ hybridization. EBV strain typing and detection of the 30 bp LMP1 deletion was performed by PCR.
Results: Of the 296 DLBCL analyzed 15 cases (5%) were EBV associated, which included 9 nodal DLBCL and 6 extranodal. Morphologically, 5 were centroblastic, 8 were polymorphic and one immunoblastic. Three cases revealed a GC phenotype whereas 12 cases showed an ABC phenotype. LMP1 was positive in a minority of tumor cells in 8 cases. The Mexican cases showed an EBV association of 7% (9 of 127) compared to 3.5% (6 of 169) of the German cases. Median ages were 63 and 72 years, respectively. Of the 8 cases analyzed from Mexico 6 were EBV type A, one with LMP-1 deletion and two were EBV type B both carried the LMP-1 deletion. Of the 6 cases analyzed from Germany 5 were type A, one of them with LMP-1 deletion and one was EBV type B without LMP1 deletion.
Conclusions: 1) EBV+ DLBCL of the elderly is more prevalent in Mexican cases compared to the German cohort (7% vs 3.5%), and similar to the frequency observed in Japan. 2) The EBV positive cases from Mexico are nearly 10 years younger than the cases from Germany (63 vs 72). 3) EBV type A predominates. 4) Mexican cases with type B-EBV always carry the 30bp LMP1 deletion, corroborating our previous findings.
Monday, March 22, 2010 1:00 PM
Poster Session II # 135, Monday Afternoon