Hodgkin’s Disease in Costa Rica:A Report of 40 Cases Analyzed for Epstein-Barr Virus

Abstract

Epstein-Barr virus (EBV) is commonly present in cases of Hodgkin's disease (HD).1 In situ hybridization studies have demonstrated that EBV DNA and RNA are preferentially located within the neoplastic Reed-Sternberg and Hodgkin (RS-H) cells, although occasional small reactive lymphocytes also may be positive.2 , 3 I m m u n o h i s t o c h e m i c a l studies h a v e shown EBV latent membrane protein-1 (LMP) expression by the RS-H cells. 4,5 In sum, the evidence implicates EBV infection in the pathogenesis of a subset of cases of HD.The presence of EBV in HD correlates with histologic and geographic factors. Epstein-Barr virus is commonly found in the RS-H cells of the mixed cellularity or lymphocytic depletion types of HD. contrast, EBV is present in the RS-H cells of approximately 25% of cases of nodular sclerosis and is rare in cases of n o d u l a r lymphocytic p r e d o m i n a n c e . 1 , 3 Others have reported that the prevalence of EBV in H D is subject to m a r k e d g e o g r a p h i c variation. Epstein-Barr virus is present in approximately 50% of HD cases in developed or industrialized countries, such as the United States and Europe. 3,6,7 In contrast, in developing countries EBV has been identified in the majority of cases of HD. 6,[8][9][10][11] The high prevalence of EBV in HD correlates with the higher incidence of the mixed cellularity type in developing countries.There is also marked geographic variation in the epidemiologic features of HD. For example, in the United States and Europe, the incidence of HD is bimodal, with incidence peaks in persons 15 to 35 years of age and in persons older than 50 years of age.12 These two peaks correspond to the peak incidence of nodular sclerosis in adolescents and young adults and to the peak incidence of mixed cellularity in persons older than 50 years. In contrast, in developing countries, the overall incidence of nodular sclerosis is lower, and mixed cellularity represents the majority of cases of HD. These data suggest that an 618

Epstein–Barr virus and Hodgkin’s lymphoma in Cairo, Egypt

“…-Middle East (including Tunisia) [4][5][6][7][8][9][10][11][12]: between 28% of cases in a series from Jordan [12] and 70% of cases from Tunisia [4] were EBV-positive with HL; for Egypt [8], 50% were positive and 67% were of the NS type, which is similar to our findings -East Africa [13][14][15][16]: between 44% and 92% of cases were positive in Kenya -Central and South America [17][18][19][20][21][22][23]: between 31% of cases in Argentina [23] and 84% of cases in Peru [17] were positive -Asia [14,[24][25][26][27][28][29][30]: between 39% of cases in China [30] and 82% of cases in India [24] were positive, and the percentage of positive cases in most other countries was high (50% to 69%). For each country, the first column shows the number (n°) of cases studied whereas the other columns show the percentages of positive cases.…”

Epstein-Barr virus (EBV) in Chinese pediatric Hodgkin disease

“…This association is striking particularly in young children, irrespective of histologic type, as EBV is present in tumor cells in 95% of cases in children age 10 years or younger. EBV infection of HRS cells was associated strongly with pediatric HD, particularly in developing countries, where it was reported in approximately 70 -100% of cases in series from Peru, 24 Honduras, 17 China, 18 Costa Rica, 42 Mexico, 43 Malaysia, 20 Kenya, 26,32,44 Saudi Arabia, 23 Iran 44 and Brazil 23 ( Table 3). 41 To our knowledge, our series is the largest of childhood HD cases to be examined for EBV to date.…”

Presencia del virus de Epstein-Barr en casos colombianos de linfoma de Hodgkin y su relación con la respuesta al tratamiento.

“…La frecuencia de casos de linfoma de Hodgkin con células de Reed-Stenberg positivas para virus de Epstein-Barr muestra una considerable variabilidad geográfica: 47% en casos norteamericanos (5,9), 50% y 45% en casos europeos (5,9 ), 54% en Argentina (10), 70% en México (11), 60% en Corea (12), 72% en Argelia (13), 96% en Perú (14), 40% en Costa Rica (15), 64,1% de casos en adultos en Brasil (16) y 100% en casos pediátricos de Honduras (17). Basados en la alta prevalencia de virus de Epstein-Barr en el linfoma de Hodgkin, algunos autores han sugerido que el linfoma de Hodgkin se puede subclasificar como virus de Epstein-Barr positivo o negativo dependiendo del subtipo histológico, de la edad en el momento del diagnóstico, del sexo y de la localización geográfica (18).…”