Pathologic Type And Relationship With EBV Infection Of Cutaneous Lymphoma

Primary cutaneous malignant lymphomas comprise a heterogeneous group of diseases with respect to clinical presentation, histopathology, prognosis and im-munophenotypic features. We know little about the pathogenesis of cutaneous lymphomas as yet. Recent researches show that the presence of EBV - encoded small RNA(EBERl/2) was detected by ISH in many type of lymphomas , especially in nasal NK/T cell lymphoma which is 100% positive for EBER1. The incidence rate of cutaneous lymphoma is low, which relationship with EB virus infection still isnt clear. Neither does nasal - type NK/T cell lymphoma. EBER is a EBV - coded functional RNA, which lies in nucleus, and which copy could reach to 10~7 ,so it' s easy to be detected. The detection of EBER ISH is strong proof of EBV infection. Primary cutaneous lymphomas represent a heterogeneous group of T - and B - cell lymphomas that show considerable variation in history, phenotype and prognosis. The incidence and distribution of cutaneous lymphomas are different in area, category, sex and age. To evaluate the features of cutaneous lymphoma of this area and the differences from other areas and countries, we retrospectively studied paraffin specimens from 18 patients of last 12 years by EBV in situ hybridization (ISH) and 7 antigens by immunohistochemis-try according to new classification of WHO in 2001.Material and Methods1. material 18 cases of cutaneous lymphomas come from the first affiliated hospital of China Medical University (1991 -2003). The age of patients including 11 male and 7 female is 11 to 79 with the average of 47. The sections were redone, cut out 4μ m sections and stained with routine HE.2. The cases were stained by polymer immunohistochemistry .3. ISH; Briefly, several 4μ m sections were deparaffinized in xylene, washed in 100% ethanol, and resuspended in protease K, then prehybridization and hybridization.Results1. Pathologic type: In the 18 cases of cutaneous lymphomas, 4 cases are B cell lymphoma, account for 22% , 14 cases are T and NK cell lymphoma, account for 78% , which include 6 cases cutaneous CD30( + ) lymphoproliferative diseases, accout for 33% , 5 cases peripheral T cell lymphomas( NOS) , account for 28% ,2 cases NK blastic lymphoma, account for 11% , and 1 case subcutaneous panniculitis - like T - cell lymphoma, account for 6% .2. ISH; In situ hybridization demonstrated a diffuse strong positive reaction for EBER1 in 1 out of 4 B cell lymphomas, and a negative reaction for EBER1 in all the T cell lymphomas.Discussions1. In cutaneous lymphoma of this area, T and NK cell lymphomas account for much more proportion than B cell lymphoma, in contrast to lymph node and intestinal tract, which accords with literature searching.2. In this area, Mycosis Fungoiders( MF) is not common, so we should change the concept that cutaneous malignant lymphoma means Mycosis Fungoiders.3. In this area, cutaneous CD30 ( + ) lymphoproliferative diseases is the most common. Recent researches found: whatever histological subtype, primary cutaneous lymphoma has good prognosis if it expresses CD30 positive antigen,...