IMPLICATION OF THE EPSTEIN-BARR-VIRUS IN THE PROGRESSION OF CHRONIC LYMPHOCYTIC-LEUKEMIA SMALL LYMPHOCYTIC LYMPHOMA TO HODGKIN-LIKE LYMPHOMAS

Low grade CLL/SLL can evolve to a spectrum of various morphologic high er grade malignancies showing Reed-Sternberg like cells. The evolution rewards Hodgkin's disease is rare but frequently associated with the presence of scattered RSL cells within the small lymphocyte proliferat ion of the CLL/SLL. The evolution towards a Richter's syndrome is more frequent and it can exhibit CD30 positive Reed-Sternberg like cells. In these Richter's syndrome cases, regarding the morphology and the ph enotype, it seems likely that there is a spectrum of lesions between t rue HD and large cell NHL. In the present study, the authors report tw o cases of transformation of CLL/SLL in non immuno-suppressed patients ; one evolved to a morphological and immunohistochemical Hodgkin's dis ease and the second to a NHL (Richter's syndrome) with numerous Reed-S ternberg like cells. In both cases, EBV has been detected within RSL c ells by immunohistochemistry and in-situ hybridization (ISH). So, the role of EBV is suggested in that kind of transformation.