Table 3.
Summary of viral studies in AR-DLBCL specimens and clinicopathological features
| Viral expression | Total, no. (%) | Pre-HAART specimens, no. (%) | HAART-era specimens, no. (%) | Median CD4 cell count per mm3 (range) | Immunoblastic/plasmablastic morphology, no (%) |
|---|---|---|---|---|---|
| Viral status* | |||||
| HIV1 p24-positive | 16/41 (39) | 4/12 (33.3) | 12/29 (41.4) | 69.5 (10-840) | 7/16 (43.75) |
| EBER-positive | 23/41 (56.1) | 11/12 (91.7) | 12/29 (41.4) | 79 (10-840) | 21/23 (91.3) |
| LANA1-positive | 2/41 (4.8)† | 1/2 | 1/2 | 51 (19-83) | 2/2 |
| Viral profiles* | |||||
| EBER+, LMP1+, p24− | 11/41 (26.8) | 6/11 (54.5) | 5/11 (45.5) | 104.5 (20-380) | |
| EBER+, LMP1−, p24− | 6/41 (14.6) | 2/6 (33.3) | 4/6 (66.7) | 36.5 (25-300) | |
| EBER+, LMP1+, p24+ | 5/41 (12.2) | 3/5 (60) | 2/5 (40) | 64 (10-100) | |
| EBER+, LMP1−, p24+ | 1/41 (2.4) | 0/1 | 1/1 | 840 | |
| EBER−, LMP1−, p24+ | 10/41 (24.4) | 1/10 (10) | 9/10 (90) | 99.5 (12-228) | |
| EBER−, LMP1−, p24− | 8/41 (19.5) | 0/8 | 8/8 (100) | 280 (25-440) |
EBER, LANA1, and LMP1 were expressed by tumor cells; p24 was expressed by reactive lymphocytes and macrophages of the microenvironment.
The 2 cases positive for the nucleoprotein LANA1 of HHV-8 (also known as Kaposi sarcoma-associated herpes virus) had a history of Kaposi sarcoma. Both were EBER+ and one was also p24+. Among EBER+ tumors (23 of 41), cases with contemporaneous LMP1 expression (16 of 23), indicative of type II or III EBV persistence, included 15 (94%) immunoblastic and 1 (6%) plasmablastic lymphoma. Morphology differed in EBV+, LMP1− tumors characteristic of type I latency (7 of 23). In these cases, we noticed 2 (29%) immunoblastic, 3 (42%) plasmablastic, and 2 (29%) centroblastic lymphomas. These findings could suggest a mechanism for EBV latent gene products in cell morphology.