Abstract
Epstein–Barr virus (EBV)-associated gastric carcinoma (EBV-GC) is not rare, accounting for 5 to 18% of all gastric carcinomas. Recently, we encountered two cases of EBV-GC of ordinary histopathological type coexistent with malignant lymphoma. One patient was a 71-year-old Japanese man who had two lesions, one in the cardia and the other in the antrum of the stomach. The former was EBV-GC without lymphoma, and antral one was EBV-GC with diffuse large B-cell lymphoma (DLBCL). The other patient was a 49-year-old Japanese man who had received chemotherapy for pelvic DLBCL 3 years earlier. He had EBV-GC with follicular lymphoma in the fundus of the stomach. In both cases, gastric carcinomas were positive for EBV-encoded small RNA by in situ hybridization, whereas the lymphoma cells, infiltrating nonneoplastic lymphocytes, and nonneoplastic epithelial cells were negative. The present cases suggest that focal immunosuppression by adjacent gastric lymphomas might be related to the alteration of the microenvironment and development of EBV-GC.
Similar content being viewed by others
References
Arikawa J, Tokunaga M, Satoh E, Tanaka S, Land CE (1997) Morphological characteristics of Epstein–Barr virus-related early gastric carcinoma: a case-control study. Pathol Int 47:360–367
Andal N, Shanthi P, Krishnan KB, Taralaxmi V (2003) The Epstein Barr virus and gastric carcinoma. Indian J Pathol Microbiol 46:34–36
Burke AP, Yen TS, Shekitka KM, Sobin LH (1990) Lymphoepithelial carcinoma of the stomach with Epstein–Barr virus demonstrated by polymerase chain reaction. Mod Pathol 3:377–380
Dickens P, Srivastava G, Loke SL, Chan CW, Liu YT (1992) Epstein–Barr virus DNA in nasopharyngeal carcinomas from Chinese patients in Hong Kong. J Clin Pathol 45:396–397
Dimery IW, Lee JS, Blick M, Pearson G, Spitzer G, Hong WK (1988) Association of the Epstein–Barr virus with lymphoepithelioma of the thymus. Cancer 61:2475–2480
Fukayama M, Chong JM, Kaizaki Y (1998) Epstein–Barr virus and gastric carcinoma. Gastric Cancer 1:104–114
Gal AA, Unger ER, Koss MN, Yen TS (1991) Detection of Epstein–Barr virus in lymphoepithelioma-like carcinoma of the lung. Mod Pathol 4:264–268
Greiner A, Kirchner T, Ott G, Marx A, Fischbach W, Muller-Hermelink HK (1996) Occurrence of multiple lymphoepithelioma-like carcinomas and MALT-type lymphoma in the stomach: detection of EBV in carcinomas but not in lymphoma. Histopathology 29:51–56
Hamilton-Dutoit SJ, Pallesen G, Franzmann MB, Karkov J, Black F, Skinhoj P, Pederson C (1991) AIDS-related lymphoma: histopathology, immunophenotype, and association with Epstein–Barr virus as demonstrated by in situ nucleic acid hybridization. Am J Pathol 138:149–163
Hamilton-Dutoit SJ, Therkidsen MH, Nielsen NH, Jensen H, Hansen JP, Pallesen G (1991) Undifferentiated carcinoma of the salivary gland in Greenlandic Eskimos: demonstration of Epstein–Barr virus DNA by in situ nucleic acid hybridization. Hum Pathol 22:811–815
Harn HJ, Chang JY, Wang MW, Ho LI, Lee HS, Chiang JH, Lee WH (1995) Epstein–Barr virus-associated gastric adenocarcinoma in Taiwan. Hum Pathol
Imai S, Koizumi S, Sugiura M, Tokunaga M, Uemura Y, Yamamoto N, Tanaka S, Sato E, Osato T (1994) Gastric carcinoma: monoclonal epithelial malignant cells expressing Epstein–Barr virus latent infection protein. Proc Natl Acad Sci USA 91:9131–9135
Kaizaki Y, Sakurai S, Chong JM, Fukuyama M (1999) Atrophic gastritis, Epstein–Barr virus infection, and Epstein–Barr virus-associated gastric carcinoma. Gastric Cancer 2:101–108
Matsunou H, Konishi F, Hori H, Ikeda T, Sasaki K, Hirose Y, Yamamichi N (1996) Characteristics of Epstein–Barr virus-associated gastric carcinoma with lymphoid storm in Japan. Cancer 77:1998–2004
Nakamura S, Aoyagi K, Iwanaga S, Yao T, Tsuneyoshi M, Fujishima M (1997) Synchronous and metachronous primary gastric lymphoma and adenocarcinoma: a clinicopathologic study of 12 patients. Cancer 79:1077–1085
Nakamura S, Yao T, Aoyagi K, Iida M, Fujishima M, Tsuneyoshi M (1997) Helicobacter pylori and primary gastric lymphoma. A histopathologic and immunohistochemical analysis of 237 patients. Cancer 79:3–11
Oda K, Tamaru J, Takenouchi T, Mikata A, Nunomura M, Saitoh N, Sarashina H, Nakajima N (1993) Association of Epstein–Barr virus with gastric carcinoma with lymphoid stroma. Am J Pathol 143:1063–1071
Saemundsen AK, Purtilo DT, Sakamoto K, Sullivan JL, Synnerholm AC, Hanto D, Simmons R, Anvret M, Collins R, Klein G (1981) Documentation of Epstein–Barr virus infection in immunodeficient patients with life-threatening lymphoproliferative disease by Epstein–Barr virus complementary RNA/DNA and viral DNA/DNA hybridization. Cancer Res 41:4237–4242
Shibata D, Weiss LM (1992) Epstein–Barr virus-associated gastric adenocarcinoma. Am J Pathol 140:769–774
Shin WS, Kang MW, Kang JH, Choi MK, Ahn BM, Kim JK, Sun HS, Min KW (1996) Epstein–Barr virus-associated gastric adenocarcinomas among Koreans. Am J Clin Pathol 105:174–181
Tokunaga M, Uemura Y, Tokudome T, Ishidate T, Masuda H, Okazaki E, Kaneko K, Naoe S, Ito M, Okamura A, Shimada A, Sato E, Land CE (1993) Epstein–Barr virus related gastric cancer in Japan: a molecular patho-epidemiological study. Acta Pathol Jpn 43:574–581
van Beek J, zur Hausen A, Klein Kranenbarg E, van de Velde CJ, Middeldrop JM, van den Brule AJ, Meijer CJ, Bloemena E (2004) EBV-positive gastric adenocarcinomas: a distinct clinicopathologic entity with a low frequency of lymph node involvement. J Clin Oncol 22:664–670
Wong NA, Herbst H, Herrmann K, Kirchner T, Krajewski AS, Moorghen M, Niedobitek F, Rooney N, Shepherd NA, Niedobitek G (2003) Epstein–Barr virus infection in colorectal neoplasms associated with inflammatory bowel disease: detection of the virus in lymphomas but not in adenocarcinomas. J Pathol 201:312–318
Wotherspoon AC, Doglioni C, Diss TC, Pan L, Moschini A, de Boni M, Isaacson PG (1993) Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet 342:575–577
zur Hausen A, van Grieken NC, Meijer GA, Hermsen MA, Bloemena E, Meuwissen SG, Baak JP, Meijer CJ, Kuipers EJ, van den Brule AJ (2001) Distinct chromosomal aberrations in Epstein–Barr virus-carrying gastric carcinomas tested by comparative genomic hybridization. Gastroenterology 121:612–618
zur Hausen H, Schulte-Holthausen H, Klein G, Henle W, Henle G, Clifford P, Santesson L (1970) EBV DNA in biopsies of Burkitt tumors and anaplastic carcinomas of the nasopharynx. Nature 228:1056–1058
Acknowledgements
The authors thank Mr. S. Yano and Ms. T. Nakamatsu for their skilled technical assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ueo, T., Kashima, K., Daa, T. et al. Coexistence of Epstein–Barr virus-associated gastric carcinoma with malignant lymphoma: report of two cases. Virchows Arch 449, 215–219 (2006). https://doi.org/10.1007/s00428-006-0193-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-006-0193-6