LYMPHOMATOID GRANULOMATOSIS - EVIDENCE THAT SOME CASES REPRESENT EPSTEIN-BARR VIRUS-ASSOCIATED B-CELL LYMPHOMA

Lymphomatoid granulomatosis is currently classified as part of a spect rum of angiocentric immunoproliferative lesions. These were initially thought to be of T-cell phenotype, but recent papers have shown that s ome cases are B-cell proliferations, sometimes associated with Epstein -Barr virus infection. We reviewed the clinicopathological features of 16 patients with pulmonary lymphomatoid granulomatosis, using immunoh istochemistry to assess the phenotype of the infiltrate, the polymeras e chain reaction to look for immunoglobulin heavy chain and T-cell rec eptor gene rearrangements, and in-situ-hybridization to look for Epste in-Barr virus infection, In seven of seven cases the atypical lymphoid population was of B-cell phenotype, with four cases showing evidence of either monoclonality or oligoclonality, All seven cases, including those that lacked unequivocal proof of malignancy, behaved aggressivel y. Epstein-Barr virus RNA was detected in four cases, We conclude that some cases of lymphomatoid granulomatosis are B-cell lymphomas, somet imes associated with Epstein-Barr virus infection.