EPSTEIN-BARR VIRUS-ASSOCIATED GASTRIC LYMPHOMA IN HONG-KONG CHINESE

We report 11 cases of gastric lymphoma that harbor the Epstein-Barr vi rus (EBV) encoded small messenger RNA, EBER-1, detected by in situ hyb ridization. The cases represented 18% of 61 consecutive gastric lympho mas from three institutions in Hong Kong between 1988 and 1993. The me an age of patients was 62 years (range, 33 to 87). The male to female ratio was 5:6. Nine of the 11 (81.8%) EBER-1+ gastric lymphomas were d iffuse large cell lymphomas of B-cell type without low grade component s. Macroscopically these lymphomas appeared either as large noncleaved cell (centroblastic) or immunoblastic type. From the available follow -up data, five of the nine patients with B-cell lymphoma were alive an d well 48, 40, 14, 13, and 12 months, respectively, after gastrectomy and chemotherapy. One patient died of postoperative pneumonia and one died of a second malignancy (esophageal squamous carcinoma) 40 months after gastrectomy. None of the EBER-1+ B-cell gastric lymphomas showed histological features characteristic of low grade lymphoma of the muc osa-associated lymphoid tissue (MALT) type reported to be common in so me Western countries. Of the two patients with T-cell lymphoma, one ha d a pleomorphic T-cell lymphoma and the other had an angiocentric lymp homa. The former was lost to follow-up after the biopsy and the latter presented with gastric perforation and died 1.5 months after gastrect omy. It is concluded that a significant proportion of gastric lymphoma s in Hong Kong Chinese are EBV-related and that they show histological features more akin to conventional node-based lymphomas than to MALT- type lymphomas. HUM PATHOL 25:947-952. Copyright (C) 1994 by W.B. Saun ders Company