Expert's Commentary
The understanding of Epstein-Barr virus associated lymphoproliferative disorder
Zhou Xiaoge, Zhang Yanlin, Xie Jianlan, Huang Yuhua, Zheng Yuanyuan, Li Wensheng, Chen Hao, Liu Fang, Pan Huaxiong, Wei Ping, Wang Zhe, Hu Yuchang, Yang Kaiyan, Xiao Hualiang, Wu Meijuan, Yin Weihua, Mei Kaiyong, Chen Gang, Yan Xiaochu, Meng Gang, Xu Gang, Li Juan, Tian Sufang, Zhu Jun, Song Yuqin, Zhang Weijing
Published 2016-12-08
Cite as Chin J Pathol, 2016, 45(12): 817-821. DOI: 10.3760/cma.j.issn.0529-5807.2016.12.001
Abstract
In recent years, there are increasing articles concerning Epstein-Barr virus associated lymphoproliferative disorder (EBV+ LPD), and the name of EBV+ LPD is used widely. However, the meaning of EBV+ LPD used is not the same, which triggered confusion of the understanding and obstacles of the communication. In order to solve this problem. Literature was reviewed with combination of our cases to clarify the concept of EBV+ LPD and to expound our understanding about it. In general, it is currently accepted that EBV+ LPD refers to a spectrum of lymphoid tissue diseases with EBV infection, including hyperplasia, borderline lesions, and neoplastic diseases. According to this concept, EBV+ LPD should not include infectious mononucleosis (IM) and severe acute EBV infection (EBV+ hemophagocytic lymphohistiocytosis, fatal IM, fulminant IM, fulminant T-cell LPD), and should not include the explicitly named EBV+ lymphomas (such as extranodal NK/T cell lymphoma, aggressive NK cell leukemia, Burkitt lymphoma, and Hodgkin lymphoma, etc.) either. EBV+ LPD should currently include: (1) EBV+ B cell-LPD: lymphomatoid granulomatosis, EBV + immunodeficiency related LPD, chronic active EBV infection-B cell type, senile EBV+ LPD, etc. (2) EBV+ T/NK cell-LPD: CAEBV-T/NK cell type, hydroa vacciniforme, hypersensitivity of mosquito bite, etc. In addition, EBV+ LPD is classified, based on the disease process, pathological and molecular data, as 3 grades: grade1, hyperplasia (polymorphic lesions with polyclonal cells); grade 2, borderline (polymorphic lesions with clonality); grade 3, neoplasm (monomorphic lesions with clonality). There are overlaps between EBV+ LPD and typical hyperplasia, as well as EBV+ LPD and typical lymphomas. However, the most important tasks are clinical vigilance, early identification of potential severe complications, and treating the patients in a timely manner to avoid serious complications, as well as the active treatment to save lives when the complications happened.
Key words:
Lymphoproliferation disorders; Herpesvirus 4, human
Contributor Information
Zhou Xiaoge
Department of Pathology, Beijing Friendship Hospital Capital Medical University, Beijing 100050, China
Zhang Yanlin
Xie Jianlan
Huang Yuhua
Zheng Yuanyuan
Li Wensheng
Chen Hao
Liu Fang
Pan Huaxiong
Wei Ping
Wang Zhe
Hu Yuchang
Yang Kaiyan
Xiao Hualiang
Wu Meijuan
Yin Weihua
Mei Kaiyong
Chen Gang
Yan Xiaochu
Meng Gang
Xu Gang
Li Juan
Tian Sufang
Zhu Jun
Song Yuqin
Zhang Weijing
