Hodgkin's disease and association with Epstein-Barr virus in children in Southeast Turkey

There are relatively few reports on histologic and immunophenotypic features of Hodgkin's disease (HD) in children in Turkey. The aim of the present study is to characterize the clinicopathologic, immunophenotypic features and Ebstein-Barr virus (EBV) status of HD in children in our region.

Fifty-two cases coded as HD in the Department of Pathology, Medical Faculty, Dicle University, Turkey, from 1990 to 2002 were retrieved. We analyzed clinicopathologic data, immunophenotype, and EBV status of all patients.

In most cases, the cervical lymph nodes were involved. The 52 cases (35 boys, 17 girls; male to female ratio was 2.1) were categorized as mixed cellularity (MC) in 23 (44.2%), lymphocyte predominance (LP) in 16 (30.8%), nodular sclerosis (NS) in 10 (19.2%), and lymphocyte depletion (LD) in 3 (5.8%). Of 33 cases, including MC and NS, Hodgkin's Reed-Sternberg cells and variants were positive for CD15 in 27 cases (81.8%) and positive for CD30 in 30 cases (90.9%). All the cases of LP demonstrated the characteristic phenotype of this variant (CD45RB+, CD20+, CD15-, CD30-). Epithelial membrane antigen stained the lymphocytic/histiocytic cells in 3 cases (18.7%) of 16. Epstein-Barr virus-LMP1 were positive in 31 cases (61.5%) of a total of 52 cases and the most were MC (91.3%).

In conclusion, mixed cellularity HD is the most common histologic subtype. This result differed from that reported in developed countries. We found a striking association with expression of EBV-latent membrane protein 1 in malignant cells in childhood HD.