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Published on: November 8, 2011
Molecular and immunophenotypic characterization of AIDS-associated, Epstein-Barr virus-negative, polyclonal lymphoma
B Shiramizu1, B Herndier, T Meeker
1Department of Pediatrics, University of California, San Francisco 94110.
Insights
A new class of AIDS-associated lymphoma, EBV-negative polyclonal B-cell lymphoma, is more prevalent than other molecular subtypes. This finding impacts understanding of HIV-associated diseases.
Area of Science:
- Oncology
- Virology
- Immunology
Background:
- Non-Hodgkin's lymphoma (NHL) is a significant concern in patients with acquired immunodeficiency syndrome (AIDS).
- Understanding the molecular characteristics of NHL in AIDS patients is crucial for diagnosis and treatment.
Purpose of the Study:
- To determine the prevalence and immunophenotype of polyclonal B-cell lymphoma in patients with AIDS.
- To analyze molecular subtypes of NHL in an AIDS cohort.
Main Methods:
- DNA extraction from 40 diagnostic biopsy specimens.
- Southern blot analysis for clonality, Epstein-Barr virus (EBV) infection, and c-myc gene rearrangement.
- Immunohistochemical analysis for lymphoma immunophenotypes.
Main Results:
- The most common genotype was polyclonal, EBV-negative NHL (35%).
- Monoclonal, EBV-positive NHL was the second most prevalent (25%).
- Polyclonal EBV-positive NHL was observed in 8% of cases.
Conclusions:
- EBV-negative, AIDS-associated, polyclonal B-cell lymphoma represents a distinct and prevalent molecular subclass.
- Absence of CD21 (EBV receptor) may contribute to the lack of EBV in this lymphoma type.
- This finding highlights a new category of HIV-associated disease.
Purpose:
A molecular analysis of non-Hodgkin's lymphomas (NHLs) from patients with AIDS was undertaken to determine the prevalence and immunophenotype of polyclonal B-cell lymphoma.
Materials And Methods:
DNA was extracted from 40 diagnostic biopsy specimens obtained from patients seen at University of California, San Francisco (UCSF) between 1986 and 1990. Clonality, infection with Epstein-Barr virus (EBV), and presence of a rearranged c-myc gene were determined by Southern blot analysis. Lymphoma immunophenotypes were determined by frozen-section immunohistochemical analysis.
Results:
The most prevalent genotype of lymphoma in this study was that of polyclonal, EBV-negative tumors with no evidence of c-myc rearrangement (14 of 40; 35%). Monoclonal, EBV-positive tumors with no evidence of c-myc rearrangement comprised the second most prevalent class (10 of 40; 25%), and polyclonal, EBV-positive tumors similar to those seen in transplant patients were observed in only a small subset (three of 40; 8%) of specimens analyzed. The immunophenotype of B cells in the polyclonal EBV-negative subset was equally divided into B-cell-predominant and mixed-phenotype lymphomas, with the latter category containing numerous infiltrating T cells. The B cells in each category were immunoglobulin M-positive (IgM+), CD20+, CD21-. All but one of the polyclonal NHLs had large-cell histology.
Conclusions:
EBV-negative, AIDS-associated, polyclonal B-cell lymphoma appears to be a new class of human immunodeficiency virus (HIV)-associated disease more prevalent in the current study than any other molecular subclass. The absence of CD21, the EBV receptor, may explain in part the absence of EBV within this polyclonal B-cell population.
