Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome

Lesions with epstein-barr virus infection

Abida K. Haque, Jeffrey L. Myers, S. David Hudnall, Benjamin Gelman, Ricardo V. Lloyd, Deborah Payne, Michael Borucki

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

We report the clinicopathologic characteristics of pulmonary lymphomatoid granulomatosis (LYG) in 11 patients (identified from a series of 330 consecutive patients who underwent autopsy between 1984 and 1995 at the University of Texas Medical Branch at Galveston, Texas) with a diagnosis of acquired immunodeficiency syndrome (AIDS). We used immunohistochemical stains, RNA in situ hybridization (ISH), and gene rearrangement studies to identify the immunophenotype and the presence or absence of Epstein-Barr virus (EBV) infection. All of the patients were men ranging in age from 27 to 65 years (mean age, 38.6 yr). Autopsy lungs of 21 age-matched controls were examined for EBV using ISH; these included 9 patients with AIDS who did not have pulmonary lesions and 12 HIV-negative individuals who died accidentally (mean age, 38.6 yr). All of the 11 pulmonary lesions showed the gross and microscopic characteristics of LYG, with zonal necrosis and prominent angioinvasion. The tumor nodules consisted of a mixture of atypical large lymphocytes, with vesicular nuclei and prominent nucleoli and with a background of small and intermediate-size lymphocytes, histiocytes, and plasma cells. The large lymphocytes were CD20 positive, consistent with a B- cell phenotype. Ten of the 11 cases demonstrated EBV1-encoded RNA and CD20 positivity in the large, atypical lymphocytes by double labeling. One patient showed EBV positivity in CD20-negative, CD45RO-positive large cells, but these cells were CD3 negative and showed a monoclonal heavy chain gene rearrangement by polymerase chain reaction, indicating that these were of B- cell origin. Aberrant CD43 coexpression was identified in four cases. EBV latent membrane protein was demonstrated in 9 of 11 cases by immunohistochemical stains. The lungs of all of the 21 control patients were negative for EBV by ISH. We conclude that, in our series, AIDS-associated LYG is a B-cell neoplasm and that it has a strong association with EBV infection.

Original languageEnglish (US)
Pages (from-to)347-356
Number of pages10
JournalModern Pathology
Volume11
Issue number4
StatePublished - Apr 1998

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Lymphomatoid Granulomatosis
Epstein-Barr Virus Infections
Acquired Immunodeficiency Syndrome
Human Herpesvirus 4
Lung
Lymphocytes
In Situ Hybridization
B-Lymphocytes
Gene Rearrangement
Autopsy
Coloring Agents
RNA
Histiocytes
Plasma Cells
Neoplasms
Membrane Proteins
Necrosis
HIV
Phenotype
Polymerase Chain Reaction

Keywords

  • AIDS
  • Epstein-Barr virus
  • Lymphomatoid granulomatosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Haque, A. K., Myers, J. L., Hudnall, S. D., Gelman, B., Lloyd, R. V., Payne, D., & Borucki, M. (1998). Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome: Lesions with epstein-barr virus infection. Modern Pathology, 11(4), 347-356.

Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome : Lesions with epstein-barr virus infection. / Haque, Abida K.; Myers, Jeffrey L.; Hudnall, S. David; Gelman, Benjamin; Lloyd, Ricardo V.; Payne, Deborah; Borucki, Michael.

In: Modern Pathology, Vol. 11, No. 4, 04.1998, p. 347-356.

Research output: Contribution to journalArticle

Haque, AK, Myers, JL, Hudnall, SD, Gelman, B, Lloyd, RV, Payne, D & Borucki, M 1998, 'Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome: Lesions with epstein-barr virus infection', Modern Pathology, vol. 11, no. 4, pp. 347-356.
Haque AK, Myers JL, Hudnall SD, Gelman B, Lloyd RV, Payne D et al. Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome: Lesions with epstein-barr virus infection. Modern Pathology. 1998 Apr;11(4):347-356.
Haque, Abida K. ; Myers, Jeffrey L. ; Hudnall, S. David ; Gelman, Benjamin ; Lloyd, Ricardo V. ; Payne, Deborah ; Borucki, Michael. / Pulmonary lymphomatoid granulomatosis in acquired immunodeficiency syndrome : Lesions with epstein-barr virus infection. In: Modern Pathology. 1998 ; Vol. 11, No. 4. pp. 347-356.
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