Brain Tumor Pathology

, Volume 31, Issue 4, pp 265–273 | Cite as

Primary central nervous system Epstein–Barr virus-positive diffuse large B-cell lymphoma of the elderly: a clinicopathologic study of five cases

  • Siraj El Jamal
  • Shiyong Li
  • Renu Bajaj
  • Zixuan Wang
  • Lawrence Kenyon
  • Jon Glass
  • Changlee S. Pang
  • Sharathkumar Bhagavathi
  • Stephen C. Peiper
  • Jerald Z. Gong
Original Article


We report five cases of primary central nervous system (CNS) Epstein–Barr virus (EBV)-positive lymphoma of the elderly. This represented an incidence of 4 % of primary CNS diffuse large B-cell lymphoma (DLBCL) after EBV screening in 134 cases. All five patients were 65 years or older with no previous history of congenital or iatrogenic immune deficiencies. The histologic morphology of all the cases was DLBCL, with variable amounts of necrosis. The cell of origin (COO) as determined by the Hans algorithm disclosed germinal center type in 2 cases and non-germinal center type in 3 cases. MYC translocation was not detected, and MYC overexpression was detected in only one case. Three patients died shortly after diagnosis, and the remaining 2 patients were in complete remission for 2 and 10 years, respectively. We conclude that EBV+ DLBCL among the elderly is uncommon in primary CNS lymphoma in the Eastern United States. The patients usually present with a single mass lesion with headache and sensorimotor symptoms. The histologic morphology is DLBCL, but clonal T-cell gene rearrangement may be detected. The outcome varies from case to case and appears to be unrelated to the COO or MYC status.


Epstein–Barr virus Central nervous system Diffuse large B-cell lymphoma Elderly 


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Copyright information

© The Japan Society of Brain Tumor Pathology 2014

Authors and Affiliations

  • Siraj El Jamal
    • 1
  • Shiyong Li
    • 2
  • Renu Bajaj
    • 1
  • Zixuan Wang
    • 1
  • Lawrence Kenyon
    • 1
  • Jon Glass
    • 3
  • Changlee S. Pang
    • 4
  • Sharathkumar Bhagavathi
    • 5
  • Stephen C. Peiper
    • 1
  • Jerald Z. Gong
    • 1
  1. 1.Department of Pathology, Anatomy and Cell BiologyThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Department of Pathology and Laboratory MedicineEmory UniversityAtlantaUSA
  3. 3.Jefferson Hospital for NeuroscienceThomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Department of PathologyWake Forest UniversityWinston-SalemUSA
  5. 5.Department of PathologyUniversity of Medicine and Dentistry New JerseyNew BrunswickUSA

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