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Review
.2014 Oct 15;9(1):34.
doi: 10.1186/1750-9378-9-34. eCollection 2014.

The role of EBV in the pathogenesis of Burkitt's Lymphoma: an Italian hospital based survey

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Review

The role of EBV in the pathogenesis of Burkitt's Lymphoma: an Italian hospital based survey

Giuseppe Pannone et al. Infect Agent Cancer..

Abstract

The exact worldwide incidence of Burkitt's lymphoma is not known. There are three distinct clinical variants of Burkitt's lymphoma, each manifesting differences in epidemiology, clinical presentation, morphology, biology and genetic features: the endemic (African), the sporadic (non-endemic), and the immunodeficiency-associated form. In particular, we reported data regarding Burkitt's lymphoma incidence in the world and across different European countries. Finally, we described clinic-pathological data of 48 Burkitt's lymphomas occurred in Italy from 2003 to 2013, in 4 different hospitals, two of which located in east side, and the other ones located in the west-coast. Forty Burkitt's lymphomas occurs in children (age range 3-12), and 8 were adulthood Burkitt's lymphomas (age range 18-87). In the pediatric group the Male:Female ratio (M:F) was of 4:1, whereas the group of the adult patients has a M:F of 1:1.67. Immunohistochemical detection of Latent Membrane Protein 1 (LMP1) expression and Epstein-Barr virus Encoded RNA (EBER) In Situ Hybridization (ISH) procedures have been performed. Lymphocyte B monoclonal spread has been demonstrated using a Polymerase Chain Reaction (PCR) based method to amplify Fragment Restriction FR1, FR2 and FR3 immunoglobulin heavy chains DNA fragments. Only 38 cases out of 48 were analyzed for LMP-1 showing various percentage of stained cells in 47.4% of the patients. Considering ISH for EBER detection results: 1 out 2 (50%) adult analyzed cases was positive, with 50% of stained tumor cells (this patient was a 22 years old female, coming from Napoli);15 out 24 (62.5%) children analyzed Burkitt's lymphomas resulted as positive for EBER;the overall positivity has been observed in 16/26 Burkitt's lymphomas (61.53%).Finally, EBV has been detected in children and adult patients, one of them with deregulation of the oncogene c-MYC by chromosomal translocation.

Keywords: Burkitt’s lymphoma; Immunohistochemistry; In situ hybridization.

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Figures

Figure 1
Figure 1
Burkitt’s lymphoma of the child - Histopathology and immunohistochemistry. a, Medium sized lymphocytes with high mitotic index and macrophages with tingible bodies (Hematoxylin-Eosin, 60x);b, CD79a expression;c, bcl6 expression;d, CD 20 expression;e, CD 10 expression;f, Ki 67 expression (LSAB-HRP, nuclear counterstaining with type II Gill’s Haematoxylin).
Figure 2
Figure 2
Burkitt’s lymphoma of the adult - Histopathology and immunohistochemistry. a, Medium sized lymphocytes with high mitotic index and macrophages with tingible bodies (Hematoxylin-Eosin, 40x);b, CD79a expression;c, bcl6 expression;d, CD 20 expression;e, CD 10 expression;f, Ki- 67 expression (LSAB-HRP, nuclear counterstaining with type II Gill’s Hematoxylin).
Figure 3
Figure 3
Immunohistochemical expression of LMP-1 in Burkitt’s lymphoma. Note the strong nuclear staining of EBV-infected cells. (LSAB-HRP, x400; nuclear counterstaining with type II Gill’s Haematoxylin).
Figure 4
Figure 4
In situ hybridization for EBER in Burkitt’s lymphoma. Note diffuse and strong staining showing early RNA transcripts of EBV accumulated in the nucleus of EBV-infected cells (Ventana® EBER ISH iView Blue Plus Kit; original magnification x200).
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