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Case Reports
. 2011 Jul;42(7):1042-6.
doi: 10.1016/j.humpath.2010.10.014. Epub 2011 Feb 11.

Adult T-cell leukemia/lymphoma with Epstein-Barr virus-positive Hodgkin-like cells

Girish Venkataraman  1 , Jonathan Berkowitz, John C Morris, John E Janik, Mark A Raffeld, Stefania Pittaluga
Affiliations
Case Reports

Adult T-cell leukemia/lymphoma with Epstein-Barr virus-positive Hodgkin-like cells

Girish Venkataraman et al. Hum Pathol. 2011 Jul.

Abstract

Hodgkin-like cells have been described in a variety of non-Hodgkin lymphomas including chronic lymphocytic leukemia and peripheral T-cell lymphoma. There have been rare reports in the Japanese population of human T-cell lymphotrophic virus-1-associated adult T-cell leukemia/lymphoma harboring Hodgkin-like cells; however, no similar cases have been described in Western patients. We report a 53-year-old African American man who presented with progressive weakness and lethargy, and was found to have generalized lymphadenopathy and hypercalcemia. A lymph node biopsy showed involvement by adult T-cell leukemia/lymphoma with scattered Epstein-Barr virus-positive cells, some of which resembled Hodgkin cells that had a B-cell phenotype, consistent with an Epstein-Barr virus-lymphoproliferative disorder. The patient had stage 4 disease with bone marrow involvement. In light of the associated B-cell lymphoproliferative process, the patient was treated with 6 cycles of intensive chemotherapy that targeted both the adult T-cell leukemia/lymphoma and the Epstein-Barr virus-lymphoproliferative disorder that resulted in a complete response. An awareness of the association of Epstein-Barr virus-lymphoproliferative disorder with Hodgkin-like cells in the context of adult T-cell leukemia/lymphoma is necessary to avoid potential misdiagnosis and to aid in therapeutic decisions.

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Figures

Figure 1
Figure 1. ATLL with Hodgkin-like cells
A, Effaced nodal architecture with sheets of medium sized atypical cells. B, Scattered large atypical lymphoid cells resembling Hodgkin/Reed-Sternberg cells (inset) are noted. C, The ATLL component strongly expressed CD4 and CD25 (inset). D, HLC express moderate PAX-5, while the small B-cell component is strongly positive. E, HLC component additionally expresses CD30. F, Numerous EBV-positive cells are identified in the background small lymphocytes and HLC (inset). G, Coexpression of EBV in a subset of B-cells (Double stain: CD20-brown-membrane; IHC/EBER-blue-nuclear; ISH).
Figure 2
Figure 2. Peripheral blood flow cytometry and molecular diagnostics
A-B, Distinct CD3dim+CD4+ population expressing CD25. C, Polyclonal Framework-III-IGH PCR D, Strong bi-allelic clonal peaks in the T-cell study.
See this image and copyright information in PMC

References

    1. White JD, Zaknoen SL, Kasten-Sportès C, Top LE, Navarro-Roman L, Nelson DL, et al. Infectious complications and immunodeficiency in patients with human T-cell lymphotropic virus I-associated adult T-cell leukemia/lymphoma. Cancer. 1995;75:1598–1607. - PubMed
    1. Bishop JF, Schimpff SC, Diggs CH, Wiernik PH. Infections During Intensive Chemotherapy for Non-Hodgkin's Lymphoma. Annals of Internal Medicine. 1981;95:549–555. - PubMed
    1. O'Mahony D, Morris JC, Stetler-Stevenson M, Matthews H, Brown MR, Fleisher T, et al. EBV-related lymphoproliferative disease complicating therapy with the anti-CD2 monoclonal antibody, siplizumab, in patients with T-cell malignancies. Clin Cancer Res. 2009;15:2514–2522. - PMC - PubMed
    1. Ohshima K, Suzumiya J, Kato A, Tashiro K, Kikuchi M. Clonal HTLV-I-infected CD4+ T-lymphocytes and non-clonal non-HTLV-I- infected giant cells in incipient ATLL with Hodgkin-like histologic features. Int J Cancer. 1997;72:592–598. - PubMed
    1. Tanaka Y, Kondo T, Kishimoto W, Kanda J, Tashima M, Mizumoto C, et al. [Epstein-Barr virus-associated B cell lymphoproliferative disorder complicated in adult T-cell leukemia] Rinsho Ketsueki. 2008;49:263–269. - PubMed

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