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Chin Med J (Taipei) 1998;61:S115.

Histologic Evaluation of Lymphomas with REAL Classification in Taiwan-Specified in the Expression of EBV in T-cell Lymphomas

Shian-Min Liu1, Kuan-Chih Chow2,4, Chang-Fang Chiu3,4, Cheng-Hawi Tzeng3, Po-Min Chen3

1Department of Pathology, 2Cancer center, 3Department of Internal Medicine; Veterans General Hospital-Taipei, Taiwan. 4Hematology-Oncology, China Medical College and Hospital, Taichun, Taiwan.

Abstract

Background The recognition of some new types of non-Hodgkin's lymphoma (NHL) and the diversity in the classification have led to the proposals of REAL classification by the International Lymphoma Study Group. The practical utility of this new classification has not been studied in this area. The association of Epstein-Barr virus (EBV) in T-cell lymphoma (TCL) was interested in the pathogenesis of malignant lymphoma.

Methods. Using REAL classification, 954 cases of fresh non-Hodgkin's lymphomas from 1988 to 1997 were reclassified based on the morphologic findings and the results of immunohistochemical studies. In situ hybridization of EBV EBER1 was applied to 106 cases of TCL.

Results. The most common types were diffuse large B cell lymphoma (37.1%), follicular center cell and diffuse small cleaved lymphomas (13.2%), marginal lymphoma (9.5%), peripheral TCL (7.4%), angiocentric immunoproliferative disease (4.0%). The prevalence of EBV in TCL was the highest in angiocentric immunoproliferative disease (86.2 %), intermediate in cases of peripheral TCL (57.1%), angioimmunblastic TCL (50%), adult T-cell lymphoma/leukemia (50%), and low in cases of lymphoblastic lymphoma (15.4%).

Conclusions. The REAL classification can be readily applied and identifies clinically distinctive types of NHL in most cases. In contrast to the western countries, a higher incidence of T-cell lymphomas is identified in this area. The high prevalence of EBV in angiocentric immunoproliferative lymphoma but not in others implies, besides the EBV, other factors may be also important in the pathogenesis of lymphomas.

Keywords: Malignant lymphoma, classification, Epstein-Barr virus, in situ hybridization

[Chin Med J (Taipei) 1998;61:S115.]

Copyright: 1998, Chinese Medical Association (Taipei)