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Primary central nervous system Epstein–Barr virus-positive diffuse large B-cell lymphoma of the elderly: a clinicopathologic study of five cases

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Abstract

We report five cases of primary central nervous system (CNS) Epstein–Barr virus (EBV)-positive lymphoma of the elderly. This represented an incidence of 4 % of primary CNS diffuse large B-cell lymphoma (DLBCL) after EBV screening in 134 cases. All five patients were 65 years or older with no previous history of congenital or iatrogenic immune deficiencies. The histologic morphology of all the cases was DLBCL, with variable amounts of necrosis. The cell of origin (COO) as determined by the Hans algorithm disclosed germinal center type in 2 cases and non-germinal center type in 3 cases. MYC translocation was not detected, and MYC overexpression was detected in only one case. Three patients died shortly after diagnosis, and the remaining 2 patients were in complete remission for 2 and 10 years, respectively. We conclude that EBV+ DLBCL among the elderly is uncommon in primary CNS lymphoma in the Eastern United States. The patients usually present with a single mass lesion with headache and sensorimotor symptoms. The histologic morphology is DLBCL, but clonal T-cell gene rearrangement may be detected. The outcome varies from case to case and appears to be unrelated to the COO or MYC status.

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Authors and Affiliations

  1. Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, USA

    Siraj El Jamal, Renu Bajaj, Zixuan Wang, Lawrence Kenyon, Stephen C. Peiper & Jerald Z. Gong

  2. Department of Pathology and Laboratory Medicine, Emory University, Atlanta, USA

    Shiyong Li

  3. Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, USA

    Jon Glass

  4. Department of Pathology, Wake Forest University, Winston-Salem, USA

    Changlee S. Pang

  5. Department of Pathology, University of Medicine and Dentistry New Jersey, New Brunswick, USA

    Sharathkumar Bhagavathi

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  1. Siraj El Jamal
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Correspondence to Jerald Z. Gong.

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Jamal, S.E., Li, S., Bajaj, R. et al. Primary central nervous system Epstein–Barr virus-positive diffuse large B-cell lymphoma of the elderly: a clinicopathologic study of five cases. Brain Tumor Pathol 31, 265–273 (2014). https://doi.org/10.1007/s10014-013-0173-x

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  • DOI: https://doi.org/10.1007/s10014-013-0173-x

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