A PATHOLOGICAL-STUDY OF HODGKINS-DISEASE IN KOREA AND ITS ASSOCIATIONWITH THE EPSTEIN-BARR-VIRUS INFECTION

BACKGROUND. The incidence of Hodgkin's disease (HD) in Korea and other Asian countries is much lower than in western countries and its assoc iation with the Epstein-Barr virus has not been well characterized. ME THODS. We evaluated the clinical, morphologic, and immunohistochemical features of 87 patients with Hodgkin's disease and also analyzed pati ents for Epstein-Barr virus (EBV) using in situ hybridization for EBV DNA, RNA, and latent membrane protein (LMP1). RESULTS. There were 68 m ales and 19 females, with a mean age of 38 years. Mixed cellularity wa s the most prevalent subtype. Expression of EBV RNA (EBER:EBV-encoded RNA) was detected in 60 of 87 cases (69%): 1 of 1 (100%) with lymphocy te predominance, nodular; 4 of 7 (57%) with lymphocyte predominance, d iffuse; 10 of 17 (59%) with nodular sclerosis; 38 of 51 (75%) with mix ed cellularity; and 7 of 11 (64%) with lymphocyte depletion. Positivit y was higher in advanced clinical stages; 4 of 7 patients (57%) with S tage I; 6 of 12 patients (50%) with Stage II; 7 of 9 patients (75%) wi th Stage III; and 5 of 5 patients (100%) with Stage nr HD EBV DNA was detected in 9 of 25 cases tested (36%). LMP1 was seen in 39 of 87 case s (45%). EBER and LMP1 positivity were higher in children and older ad ults than in adults aged between 15-50 years. Immediate early mRNAs (B HLF:Bam H-fragment, lower strand frame) was seen in a single patient. CONCLUSIONS. HD in Korea showed a high incidence of mixed cellularity subtype and a high prevalence of EBV. EBV was detected in all subtypes , including a case of nodular lymphocytic predominance, and in all age groups, and showed correlation with mixed cellularity subtype and hig her clinical stage. The expression of EBER and LMP were more frequentl y seen in children and older adults, suggesting a lowered immune surve illance in those age groups or a different pathophysiology of HD among different age groups. (C) 1996 American Cancer Society.