Abstract
The frequency and clinical features of Epstein–Barr virus (EBV)-associated primary central nervous system lymphoma (PCNSL) in elderly patients were investigated in this study. Thirty-three PCNSL cases were enrolled in the retrospective study. Biopsies were performed, and tissue was embedded in paraffin and sectioned. In-situ hybridization of EBV-encoded small RNAs was then conducted. Specimens were scored as having one of three possible results: negative (no EBV-positive cells), slightly positive (<50% EBV-positive cells), and strongly positive (>50% EBV-positive cells). Fifteen cases were negative for EBV expression. Sixteen cases were slightly positive, and two cases (68 and 79 years of age) were strongly positive. The incidence of strongly positive EBV expression in PCNSL was 6.1%. The incidence of strongly positive EBV expression in PCNSL patients ≥65 years of age was 13%. Median survival time differed significantly among PCNSL patients treated with high-dose methotrexate and radiotherapy. Importantly, the strongly EBV-positive PCNSL cases had the worst outcomes, and the EBV-negative PCNSL cases had the best outcomes. These results suggest that EBV infection may affect the treatment outcome of PCNSL. In the future, examination of EBV expression in PCNSL patients who receive individualized treatment may be useful.
Similar content being viewed by others
References
Committee of Brain Tumor Registry of Japan (2003) Report of brain tumor registry of Japan (1984–2000) Part I General features of brain tumors. Neurol Med Chir (Tokyo) 49 Suppl:S1–S25
Oyama T, Ichimura K, Suzuki R et al (2003) Senile EBV + B-cell lymphoproliferative disorders: a clinicopathologic study of 22 patients. Am J Surg Pathol 27:16–26
Kleinschmidt-DeMasters BK, Damek DM, Lillehei KO et al (2008) Epstein Barr virus-associated primary CNS lymphomas in elderly patients on immunosuppressive medications. J Neuropathol Exp Neurol 67:1103–1111
Hsiao SC, Ichinohasama R, Lin S et al (2009) EBV-associated diffuse large B-cell lymphoma in a psoriatic treated with methotrexate. Pathol Res Pract 205:43–49
Sierra del Rio M, Rousseau A, Soussain C et al (2009) Primary CNS lymphoma in immunocompetent patients. Oncologist 14:526–539
Oyama T, Yamamoto K, Asano N et al (2007) Age-related EBV-associated B-cell lymphoproliferative disorders constitute a distinct clinicopathologic group: a study of 96 patients. Clin Cancer Res 13:5124–5132
Gibson SE, His ED (2009) Epstein–Barr virus-positive B-cell lymphoma of the elderly at a United States tertiary medical center: an uncommon aggressive lymphoma with a nongerminal center B-cell phenotype. Hum Pathol 40:653–661
Kuze T, Nakamura N, Hashimoto Y et al (2000) The characteristic of Epstein–Barr virus (EBV)-positive diffuse large B-cell lymphoma: comparison between EBV+ and EBV− cases in Japanese population. Jpn J Cancer Res 91:1233–1240
Park S, Lee J, Ko YH et al (2007) The impact of Epstein–Barr virus status on clinical outcome in diffuse large B-cell lymphoma. Blood 110:972–978
Yoshino T, Nakamura S, Matsuno Y et al (2006) Epstein–Barr virus involvement is a predictive factor for the resistance to chemoradiotherapy of gastric diffuse large B-cell lymphoma. Cancer Sci 97:163–166
Kitai R, Matsuda K, Adachi E et al (2010) Epstein–Barr virus-associated primary central nervous system lymphoma in the Japanese population. Neurol Med Chir (Tokyo) 50:114–118
Sugita Y, Terasaki M, Niino D et al (2010) Epstein–Barr virus-associated primary central nervous system lymphomas in immunocompetent elderly patients: analysis for latent membrane protein-1 oncogene deletion and EBNA-2 strain typing. J Neurooncol 100:271–279
Ouyang Q, Wagner WM et al (2003) An age-related increase in the number of CD8+ T-cells carrying receptors for an immunodominant Epstein–Barr virus (EBV) epitope is counteracted by a decreased frequency of their antigen-specific responsiveness. Mech Ageing Dev 124:477–485
Fagnoni FF, Vescovini R, Passeri G et al (2000) Shortage of circulating naïve CD8+ T cells provides new insights on immunodeficiency in aging. Blood 95:2860–2868
Thorley-Lawson DA, Gross A (2004) Persistence of the Epstein–Barr virus and the origins of associated lymphomas. N Engl J Med 350:1328–1337
Morales D, Beltran B, De Mendoza FH et al (2010) Epstein–Barr virus as a prognostic factor in de novo nodal diffuse large B-cell lymphoma. Leuk Lymphoma 51:66–72
Clybouw C, McHichi B, Mouhamad S et al (2005) EBV infection of human B lymphocytes leads to down-regulation of Bim expression: relationship to resistance to apoptosis. J Immunol 175:2968–2973
Snow AL, Lambert SL, Natkunam Y et al (2006) EBV can protect latently infected B cell lymphomas from death receptor-induced apoptosis. J Immunol 177:3283–3293
Roychowdhury S, Peng R, Baiocchi RA et al (2003) Experimental treatment of Epstein–Barr virus-associated primary central nervous system lymphoma. Cancer Res 63:965–971
Soussain C, Muldoon LL, Varallyay C et al (2007) Efficacy and MRI of rituximab and methotrexate treatment in a nude rat model of CNS lymphoma. Clin Cancer Res 13:2504–2511
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Utsuki, S., Oka, H., Miyajima, Y. et al. Epstein–Barr virus (EBV)-associated primary central nervous system lymphoma: is incidence of EBV expression associated with median survival time?. Brain Tumor Pathol 28, 145–149 (2011). https://doi.org/10.1007/s10014-011-0020-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10014-011-0020-x