EPSTEIN-BARR-VIRUS IN B-CELL LYMPHOMAS ASSOCIATED WITH CHRONIC SUPPURATIVE INFLAMMATION

Chronic antigenic stimulation is considered to play an important role in neoplastic lymphoid transformation, This paper describes three case s of non-Hodgkin lymphomas (NHLs) associated with long-standing chroni c suppuration, Two were primary bone lymphomas associated with long-st anding chronic osteomyelitis and one was a primary skin lymphoma assoc iated with chronic venous ulcers with a latent period of 13 years, All mere diffuse large B-cell lymphomas, with plasmacytoid differentiatio n in two cases, Epstein-Barr virus (EBV)-encoded RNAs were demonstrate d in virtually all tumour cells in all cases by ill situ hybridization , Immunohistochemistry revealed EBV-encoded latent membrane protein (L MP)-1 expression in one case and BZLF1 protein expression in all three cases, whilst the EBV-encoded nuclear antigen (EBNA)-2 was not detect ed, Kaposi's sarcoma-associated herpesvirus (KSHV) sequences were abse nt in two cases studied, Our cases show similarities with pyothorax-as sociated pleural lymphomas reported mainly from Japan and recently fro m France, which are invariably associated with EBV. These findings sug gest a causal effect of EBV in the development of this type of lymphom a complicating long-standing chronic suppuration. Localized immunodepr ession induced by chronic inflammation or immunosuppressive cytokines may favour the clonal proliferation of EBV-infected B cells. (C) 1997 John Wiley & Sons, Ltd.