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Int J Clin Exp Pathol 2010;4(1):100-110

Case Report
Epstein-Barr Virus Positive Anaplastic Large Cell Lymphoma: Myth or Reality?

Ly Ma, Youval Katz, Kanu P. Sharan, Roland Schwarting, Annette S. Kim

Department of Pathology, Robert Wood Johnson, Department of Pathology, Cooper University Hospital, Department of Hematology and
Oncology, Cooper University Hospital, Department of Pathology, Vanderbilt University Medical Center, Nashville, TN  37232, USA

Received September 15, 2010; accepted December 15, 2010; Epub November 20, 2010; published January 1, 2011

Abstract: The World Health Organization (WHO) Classification of Tumours of Haematopoietic and Lymphoid Tissue, 2008 edition, states that
anaplastic large cell lymphoma (ALCL) is “consistently negative for Epstein-Barr virus (EBV)”. The statement made by the WHO has led to the
widespread belief that EBV can have no pathogenic role in ALCL. Herein we report a case of an immunocompetent 35-year-old male who
presented with hemophagocytic syndrome secondary to lymphoma for which diagnostic material consisted solely of a bone marrow biopsy.
The biopsy demonstrated large anaplastic cells which were uniformly positive for surface CD3, CD30, CD45, TIA-1 and Granzyme B but
negative for ALK-1. In-situ hybridization was strongly positive for EBER in the large neoplastic cells. The uniformity of CD30 expression on the
neoplastic cells raises the possibility of an EBV-associated ALCL, ALK-. Discussion of this case as well as a retrospective review of 64 cases
of reported of EBV+ ALCL are presented. (IJCEP1009004).

Keywords: Epstein-Barr virus, anaplastic large cell lymphoma, ALK

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Address all correspondence to:
Annette S. Kim, MD, PhD,
Department of Pathology,
Vanderbilt University Medical Center,
1301 Medical Center Drive, 4603A TVC
Nashville, TN  37232-5310, USA
Tel: 615-343-7745
Fax: 615-343-7961