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[Aggressive cutaneous T-cell lymphoma associated with the presence of Epstein-Barr virus. 2 cases]
Introduction:
The factors of prognosis of the cutaneous T-cell lymphomas are less well known as those of the B-cell lymphomas and the role of the Epstein-Barr virus (EBV) is not yet definitively evaluated.
Case Reports:
Two male patients aged 62 and 82 years had a mycosis fungoides with a lethal outcome. The first patient had mutilating facial tumors; the RNA m of EBV and the genome of EBV were demonstrated in the diseased skin. The second patient had an erythrodermic course with enlarged peripheral lymph nodes and circulating Sézary's cells; the genome of EBV was demonstrated by PCR in the diseased skin.
Discussion:
The role of the EBV has already been demonstrated in peripheral aggressive T-cell lymphomas. In the mycosis fungoides, the EBV is associated with the lesions in 0 to 32 p. cent according to the published series. EBV associated T-cell lymphomas have a poor survival rate and the EBV infection may be associated with the expression of the multidrug resistant gene-1 (MDR-1) and the risk of a terminal hemophagocytosis. In our both patients the presence of the EBV in the lymphocytes of the skin lesions is also an argument in favour of the pathogenic role of the virus.
Insights
Epstein-Barr virus (EBV) DNA was detected in two mycosis fungoides patients with lethal outcomes. This suggests EBV may play a role in aggressive cutaneous T-cell lymphomas and poor survival rates.
Area of Science:
- Oncology
- Virology
- Dermatology
Background:
- Prognostic factors for cutaneous T-cell lymphomas (CTCLs) are less understood than for B-cell lymphomas.
- The specific role of Epstein-Barr virus (EBV) in CTCLs remains to be definitively established.
Observation:
- Two male patients (62 and 82 years old) with mycosis fungoides experienced fatal outcomes.
- EBV RNA and DNA were identified in the skin lesions of the first patient, who had mutilating facial tumors.
- EBV DNA was detected via PCR in the skin lesions of the second patient, who presented with erythrodermic CTCL and Sézary cells.
Findings:
- The presence of EBV in lymphocytes within skin lesions supports its potential pathogenic role in these CTCL cases.
- EBV association in mycosis fungoides ranges from 0-32% across published studies.
- EBV-associated T-cell lymphomas are linked to poorer survival rates, potential MDR-1 gene expression, and hemophagocytosis risk.
Implications:
- These findings contribute to understanding the prognostic factors in CTCL.
- Further research into EBV's role in CTCL pathogenesis and its impact on patient outcomes is warranted.
- This study highlights the potential link between EBV infection and aggressive disease progression in mycosis fungoides.