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Burkittov lymfóm s nezvyčajnou granulomatóznou reakciou. Kazuistika


: A. Janegová 1;  P. Janega 1,2;  D. Ilenčíková 3;  P. Babál 1
: Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic 1;  Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovak Republic 2;  National Cancer Institute, Department of Clinical Genetics, Bratislava, Slovak Republic 3
: Čes.-slov. Patol., 47, 2011, No. 1, p. 19-22
: Original Article

Výskyt granulomatóznej reakcie sprevádzajúcej rôzne druhy nádorov bol už v minulosti opísaný. Spomedzi lymfoproliferatívnych chorôb, vykazuje tvorbu granulómov predovšetkým Hodkinov lymfóm a T-bunkové non-Hodkinove lymfómy (NHL). V B-bunkových NHL, ako je Burkittov lymfóm, sú granulomatózne reakcie zriedkavé. V tejto práci predstavujeme prípad sporadického Burkittovho lymfómu sprevádzaného tvorbou granulómov pripomínajúcich sarkoidózu. Klinické, laboratórne, ani histologické vyšetrenie nepreukázalo prítomnosť infekčných agens, resp. nesvedčilo pre diagnózu sarkoidózy. In situ hybridizáciou a polymerázovou reťazovou reakciou sa v tkanive dokázala prítomnosť Epstein-Barrovej vírusu (EBV). Negativita imunohistochemicky stanovovaného vírusového latentného membránového proteínu 1 (LMP1) spolu s predchádzajúcimi vyšetreniami svedčí v tomto prípade pre typ I latentnej EBV infekcie. Cytogenetická analýza s použitím fluorescenčnej in situ hybridizácie odhalila mutáciu génu c-MYC spolu s naznačenou fúziou MYC/IgL. Absencia EBV v histiocytoch podporuje skôr reaktívny charakter granulomatóznej reakcie na nádorový proces. Biologický a prognostický význam vzniku týchto granulómov sprevádzajúcich Burkittov lymfóm a úloha EBV infekcie v tomto vzťahu zostáva však nejasná.

Kľúčové slová:
Burkittov lymfóm – granulomatózna reakcia - Epstein-Barrovej virus - EBV


Sources

1. Corapćioglu F, Basar EZ, Demirel A et al. Granulomatous reaction in mediastinal B-cell non-Hodgkin lymphoma and intracardiac thrombosis. Pediatr Hematol Oncol 2008; 25: 217-226.

2. Khurana KK, Stanley MW, Powers CN, Pitman MB. Aspiration cytology of malignant neoplasms associated with granulomas and granuloma-like features: diagnostic dilemmas. Cancer 1998; 84: 84-91.

3. Brincker H. Sarcoid reactions in malignant tumours. Cancer Treat Rev 1986; 13: 147-156.

4. Hollingsworth HC, Longo DL, Jaffe ES. Small noncleaved cell lymphoma associated with florid epithelioid granulomatous response. A clinicopathologic study of seven patients. Am J Surg Pathol 1993; 17: 51-59.

5. Dunphy CH, Panella MJ, Grosso LE. Low-grade B-cell lymphoma and concomitant extensive sarcoidlike granulomas: a case report and review of the literature. Arch Pathol Lab Med 2000; 124: 152-156.

6. Haralambieva E, Rosati S, van Noesel C, et al. Florid granulomatous reaction in Epstein-Barr virus-positive nonendemic Burkitt lymphomas: report of four cases. Am J Surg Pathol 2004; 28: 379-383.

7. Hall PA, Kingston J, Stansfeld AG. Extensive necrosis in malignant lymphoma with granulomatous reaction mimicking tuberculosis. Histopathology 1988; 13: 339-346.

8. Schrager JA, Pittaluga S, Raffeld M, Jaffe ES. Granulomatous reaction in Burkitt lymphoma: correlation with EBV positivity and clinical outcome. Am J Surg Pathol 2005; 29(8): 1115-1116.

9. Hummel M, Bentink S, Berger H. A biologic definition of Burkitt’s lymphoma from transcriptional and genomic profiling. N Engl J Med 2006, 354, 2419-2430.

10. Braylan RC, Long JC, Jaffe ES, Greco FA, Orr SL, Berard CW. Malignant lymphoma obscured by concomitant extensive epithelioid granulomas: report of three cases with similar clinicopathologic features. Cancer 1977; 39: 1146-1155.

11. Manipadam MT, Viswabandya A, Srivastava A. Primary splenic marginal zone lymphoma with florid granulomatous reaction - a case report and review of literature. Pathol Res Pract 2007; 203: 239-243.

12. Asakawa H, Tsuji M, Tokumine Y. Gastric T-cell lymphoma presenting with epithelioid granulomas mimicking tuberculosis in regional lymph nodes. J Gastroenterol 2001; 36: 190-194.

13. Brunner A, Kantner J, Tzankov A. Granulomatous reactions cause symptoms or clinically imitate treatment resistance in small lymphocytic lymphoma/chronic lymphocytic leukaemia more frequently than in other non-Hodgkin lymphomas. J Clin Pathol 2005; 58: 815-819.

14. Chopra R, Rana R, Zachariah A, Mahajan MK, Prabhakar BR. Epithelioid granulomas in Hodgkin’s disease—prognostic significance. Indian J Pathol Microbiol 1995; 38: 427-433.

15. O’Connell MJ, Schimpff SC, Kirschner RH, Abt AB, Wiernik PH. Epithelioid granulomas in Hodgkin disease. A favorable prognostic sign? JAMA 1975; 233: 886-889.

16. Sacks EL, Donaldson SS, Gordon J, Dorfman RF. Epithelioid granulomas associated with Hodgkin’s disease: clinical correlations in 55 previously untreated patients. Cancer 1978; 41: 562-567.

17. Urbano-Ispizua A, Campo E, Feliu E, et al. Non-Hodgkin’s lymphoma with splenic granulomatous reaction. Med Clin (Barc) 1989; 92: 661-664.

18. Mitarnun W. Granulomatous reaction in peripheral T-cell proliferative disease: a case report. J Med Assoc Thai 1997; 80: 795-798.

19. Fiala M, Colodro I, Talbert W, Ellis R, Chatterjee S. Bone marrow granulomas in mononucleosis. Postgrad Med J 1987; 63: 277-279.

20. Ban S, Goto Y, Kamada K et al. Systemic granulomatous arteritis associated with Epstein-Barr virus infection. Virchows Arch 1999; 434: 249-254.

21. Andersson J, Isberg B, Christensson B, Veress B, Linde A, Bratel T. Interferon gamma (IFN-gamma) deficiency in generalized Epstein-Barr virus infection with interstitial lymphoid and granulomatous pneumonia, focal cerebral lesions, and genital ulcers: remission following IFN-gamma substitution therapy. Clin Infect Dis 1999; 28: 1036-1042.

22. Chung HJ, Chi HS, Cho YU, Jang S, Park CJ. Bone marrow fibrin-ring granuloma: review of 24 cases. Korean J Lab Med 2007; 27: 182-187.

23. Harabuchi Y, Yamanaka N, Kataura A, et al. Epstein-Barr virus in nasal T-cell lymphomas in patients with lethal midline granuloma. Lancet 1990; 335: 128-130.

24. Basu D, Bundele M. Angioimmunoblastic T-cell lymphoma obscured by concomitant florid epithelioid cell granulomatous reaction - a case report. Indian J Pathol Microbiol 2005; 48: 500-502.

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