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与成人系统性、慢性、活动性 Epstein-Barr 病毒相关的 T-/NK 细胞淋巴增殖性肿瘤的特征:西方人群 5 例报告

英文原题:Characterization of T-/natural killer cell lymphoproliferative neoplasms associated with systemic, chronic, active Epstein-Barr virus in adults: A report of 5 cases in a Western population.

查看英文原题

Characterization of T-/natural killer cell lymphoproliferative neoplasms associated with systemic, chronic, active Epstein-Barr virus in adults: A report of 5 cases in a Western population.

PubMed 2024/06/03(内容时间) Am J Clin Pathol Q2 · IF 2.3(JCR 2025)

分数与星级只用于站内排序 —— 不代表疗效、安全性或个人适用性。

研究概要

该诊断在亚洲最为普遍,西方国家报道的病例较少。成人年龄是预后不良的独立危险因素,且大多数病例在儿科人群中得到诊断。

研究思路结论见上方概要

由于在成人群体中频率较低,且临床和实验室表现与噬血细胞性淋巴组织细胞增多症及其他T细胞淋巴瘤重叠,T细胞/自然杀伤(NK)细胞系统性、慢性、活动性EBV(EBV)(T/NK sCAEBV)感染仍被诊断不足,阻碍了关键、及时的治疗干预。

我们报告了一个5例系列,包括2例成人T/NK sCAEBV患者和3例额外伴有全身性EBV感染的成人T/NK淋巴瘤患者,以回顾这些疾病重叠的诊断和临床特征。

全球约95%的人口在一生中感染过EBV,感染通常无症状,有症状的病例最终可自行消退。一小部分免疫功能正常的患者会发展为CAEBV,这是一种由EBV感染的T细胞或NK细胞肿瘤性淋巴细胞引起的危及生命的并发症。T/NK sCAEBV的终末器官损伤部位表现为反应性淋巴组织增生等病理学改变,使得诊断难以确立,唯一可治愈的选择是异基因造血干细胞移植。

展开英文摘要原文

Because of its low frequency in adult populations and clinical and laboratory overlap with hemophagocytic lymphohistiocytosis and other T-cell lymphomas, T-cell/natural killer (NK) cell systemic, chronic, active Epstein-Barr virus (EBV) (T/NK sCAEBV) infection remains underdiagnosed, preventing critical, prompt therapeutic interventions.

We report a 5-case series that included 2 adult patients with T/NK sCAEBV and 3 additional adult patients with T/NK lymphomas with concomitant systemic EBV infection to review these entities' overlapping diagnostic and clinical features.

Approximately 95% of the world population has been infected with EBV during their lifetime, and infection is usually asymptomatic, with symptomatic cases eventually resolving spontaneously. A small subset of immunocompetent patients develops CAEBV, a life-threatening complication resulting from EBV-infected T-cell or NK cell neoplastic lymphocytes. The sites of end-organ damage in T/NK sCAEBV demonstrate pathologic findings such as reactive lymphoid proliferations, making the diagnosis difficult to establish, with the only curative option being an allogeneic hematopoietic stem cell transplant.

This diagnosis is most prevalent in Asia, with few cases reported in Western countries. Adult age is an independent risk factor for poor outcomes, and most cases are diagnosed in pediatric populations.

论文信息

作者
Murga-Zamalloa C、Stone MB、Gutierrez MG、Hippalgaonkar NR、Tariq H、Sadeh M、Mehta A、Khan I
第一作者单位
Department of Pathology, University of Illinois at Chicago, Chicago, IL, US.United States
通讯作者单位
Department of Pathology & Laboratory Medicine, Cleveland Clinic Florida, Weston, FL, US.United States
文献类型
病例报告
期刊
American journal of clinical pathology2024 Jun 3
原文标识
PubMed 38345307 · DOI 10.1093/ajcp/aqad184