Peripheral lymphoid cells, from 12 cases of acute infectious mononucleosis (IM), were tested in a micro chromium-51 release assay for cytotoxic activity against a variety of cell lines that did or did not carry the Epstein-Barr virus (EBV) genome. Unfractionated lymphocytes from these patients were cytotoxic to both types of cell lines, as were lymphocytes from healthy individuals. If, however, lymphocytes bearing complement receptors were removed, the residual IM lymphocyte fraction was specifically cytotoxic for EBV-genome-carrying cell lines. The residual lymphocyte fraction in normal donors had no such effect. Heterophile-positive IM is caused by EBV, and these results indicate that, during the acute phase of this disease, patients harbor killer cells, probably T cells, which specifically kill EBV-genome-carrying B cells in vitro. No such specificity for EBV-genome-positive target cells was found in normal lymphocytes stimulated in vitro with autologous EBV-genome-positive lymphoblastoid cells. Such stimulated cells were highly cytotoxic to both genome-positive and negative lines after removal of complement receptor-positive lymphocytes.The Epstein-Barr virus (EBV) has been regularly associated with three human diseases; infectious mononucleosis (IM) (1), Burkitt's lymphoma (BL) (2), and nasopharyngeal carcinoma (2). The etiologic role of this virus is clearly established in IM, whereas, it remains suggestive but not proven in BL and nasopharyngeal carcinoma. IM is characterized by an intensive lymphoproliferation which, although it sometimes resembles the acute phase of leukemia, always is self-limiting and benign in character. This self-limitation in viw is in contrast to the capacity of the patient's lymphocytes to proliferate indefinitely in vitro as continuous cell lines with surface characteristics typical for bone-marrow derived (B) lymphocytes (2). Such cell lines carry the EBV genome, as shown by nucleic acid hybridization or the presence of the EBV-associated nuclear antigen (EBNA) (2, 3). It would be essential to understand what mechanisms protect the IM patients from continuous lymphoproliferation.Recent investigations have shown that a high proportion of the blast-transformed cells found in the peripheral blood of IM patients are thymus-derived (T) lymphocytes (4-7).As T lymphocytes are known to be the major defense mechanism in many viral infections (8), we have studied the capacity of lymphocytes isolated from IM patients to kill a variety of cell lines that do or do not carry the EBV genome. Furthermore, we have compared the target cell specificity of the IM lymphocytes with the specificity of lymphocytes stimulated in vitro with autologous EBV-genome-carrying cell lines.

FNAC is an accurate method in the diagnosis of lymphomas when the cytologic diagnosis is corroborated by immunophenotyping. However, an increasing use of FNAC for primary diagnosis and classification of lymphomas may result in a loss of archival tissue for complementary analyses, reclassification, and research purposes. In addition, some of the lymphoma entities are impossible to diagnose with use of the FNAC technique.

After removal of SRBC rosette-forming T-cells from the peripheral blood, the residual, largely B-lymphocyte fraction of five infectious mononucleosis patients was found to contain 0.5-2% blast cells, positive for the EBV-determined nuclear antigen (EBNA). There was a rough parallelism between the presence of large lymphoblasts in the hematological smear, EBNS-positive large blasts in the B-cell fraction and the ability of the T-cell fraction to exert an EBV-specific lymphocytotoxicity on established cell lines in vitro. EBNA-positive B-cells and EBV-specific killer T-cells disappeared after the acute phase of the disease.

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Elderly Hodgkin lymphoma patients still do poorly and improved prognostics, personalized and targeted treatment options associated with fewer side-effects will hopefully advance the clinical Hodgkin lymphoma field.