bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2021-66-4-567-579bloodjour-322Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESХарактеристика и частота диагностики вариантов вирус Эпштейна — Барр-позитивной лимфомы Ходжкина с лимфоидным преобладанием в структуре лимфомы ХоджкинаThe characterization and frequency of diagnosis of EBV-positive variants with a lymphoid predominance in the structure of Hodgkin lymphomahttps://orcid.org/0000-0003-0922-9314ШуплецоваИ. А.ShupletsovaI. A.

Шуплецова Ирина Александровна, кандидат медицинских наук, врач-патологоанатом патологоанатомического отделения 

125167, Москва

Irina A. Shupletsova, Cand. Sci. (Med.), Pathologist, Department of Pathology 

125167, Moscow

shupletsova.i@blood.ruhttps://orcid.org/0000-0002-1082-8659КовригинаА. М.KovriginaA. M.

Ковригина Алла Михайловна, доктор биологических наук, заведующая патологоанатомическим отделением 

125167, Москва

Alla M. Kovrigina, Dr. Sci. (Biol.), Head of the Pathological Department 

125167, Moscow

kovrigina.a@blood.ruФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияNational Research Center for HematologyRussian Federation202101122021664567579Copyright © Шуплецова И.А., Ковригина А.М., 20212021Шуплецова И.А., Ковригина А.М.Shupletsova I.A., Kovrigina A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/322Введение

Введение. Вирус Эпштейна  — Барр (ВЭБ) играет важную роль в  патогенезе лимфомы Ходжкина (ЛХ). Частота экспрессии ВЭБ варьирует при различных гистологических вариантах классической ЛХ и практически не встречается при нодулярной ЛХ с лимфоидным преобладанием.

Цель — изучить патоморфологические особенности гистологических вариантов ЛХ с лимфоидным преобладанием, ассоциированных с ВЭБ, и частоту диагностики.

Материалы и методы

Материалы и методы. В ретроспективное исследование включены 794 больных с верифицированным диагнозом ЛХ с  помощью гистологического и  иммуногистохимического исследований на  биопсийном материале за  период 2018–2019  гг. (возрастной диапазон  — 18–91  год; медиана  — 34  года; мужчины: женщины  — 1,1: 1). Наличие ВЭБ в биоптатах оценивалось с помощью иммуногистохимической реакции с антителами к ВЭБ (клон LMP1), или хромогенной in situ гибридизации с зондами к малым молекулам РНК ВЭБ.

Результаты

Результаты. Классическая ЛХ диагностирована в 91 % случаев, нодулярная ЛХ с лимфоидным преобладанием — в 9 % случаев. ВЭБ-позитивная ЛХ составила 11 % от всех случаев классической ЛХ, возрастной диапазон — 18– 81 год (медиана — 45 лет); соотношение мужчины: женщины — 2,5: 1. Все случаи нодулярной ЛХ с лимфоидным преобладанием были ВЭБ-негативными. Гистологический вариант классической ЛХ, богатой лимфоцитами, был установлен у 14 (2 %) из 725 больных, из них у 4 больных были выявлены «перекрестные» морфоиммуногистохимические признаки с нодулярной ЛХ с лимфоидным преобладанием, которые отличались от классической ЛХ наличием В-зон в виде крупных нодулей (р = 0,0157) и экспрессией опухолевыми клетками CD20 (p = 0,0404).

Заключение

Заключение. Для нодулярной ЛХ с лимфоидным преобладанием не характерна связь с ВЭБ-инфекцией, в отличие от классической ЛХ, богатой лимфоцитами. Полученные данные свидетельствуют в пользу концепции существования транзиторной формы ЛХ, обладающей чертами нодулярной ЛХ с лимфоидным преобладанием и классической ЛХ, в патогенезе которой играет роль ВЭБ.

Introduction

Introduction. Epstein — Barr virus (EBV) plays an important role in the pathogenesis of lymphoid tumors, in particular Hodgkin lymphoma. The frequency of expression of the EBV varies in different histological variants of classical Hodgkin lymphoma and is rarely observed in nodular lymphocyte predominant Hodgkin lymphoma.

Aim — to study the pathomorphological features of the histological variants of Hodgkin lymphoma with lymphoid predominance associated with the EBV, as well as the frequency of their diagnosis in the structure of Hodgkin lymphoma.

Materials and methods

Materials and methods. The retrospective study included 794 patients with a verified diagnosis of Hodgkin lymphoma using histological and immunohistochemical methods on biopsy material for the period 2018–2019 (age range — 18–91 years old; median — 34 years old; men : women — 1.1 : 1). The presence of EBV in biopsies was assessed by immunohistochemical reaction with antibodies to EBV (clone LMP1), or by chromogenic in situ hybridization with probes for EBV-encoded small RNAs.

Results

Results. Classical Hodgkin lymphoma was diagnosed in 91 % (725/794) cases, nodular lymphocyte predominant Hodgkin lymphoma — in 9 % (69/794) cases. EBV-positive Hodgkin lymphoma accounted for 11 % (82/725) of all cases of classical Hodgkin lymphoma, (age range — 18–81 years old, median — 45 years old; men : women — 2.5 : 1). All cases of nodular lymphocyte predominant Hodgkin lymphoma were EBV-negative. Lymphocyte-rich classical Hodgkin lymphoma was found in 14 patients (14/725, 2 %), 4 patients showed intermediate morphoimmunohistochemical features with nodular lymphocyte predominant Hodgkin lymphoma, which were statistically significantly different from classical Hodgkin lymphoma by the presence of B-zones in the form of large nodules (p = 0.0157) and expression CD20 by tumor cells (p = 0.0404).

Conclusion

Conclusion. Nodular lymphocyte predominant Hodgkin lymphoma is not characterized by a connection with EBV infection, unlike classical variant — lymphocyte-rich classical Hodgkin lymphoma. The obtained data support the concept of the existence of a transient form of Hodgkin lymphoma, which has the features of nodular lymphocyte predominant Hodgkin lymphoma and classical Hodgkin lymphoma, in the pathogenesis of which the Epstein — Barr virus likely plays a role. 

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The authors declare that there are no conflicts of interest present.