Author : S. Saeed, Mohammed
Annals of the College of Medicine, Mosul,
2009, Volume 35, Issue 2, Pages 93-103
Objectives: 1- To determine the association between Hodgkin's lymphoma and Epstein-Barr virus. 2- To determine if it is related to certain age groups or specific histologic subtypes. 3- To compare the pattern with other developing or developed countries.Methods: Biopsies of seventy cases with Hodgkin's lymphoma were collected from the pathology laboratories. The clinical data, including the patient’s age, sex, site of lymph node affected and the histological classification according to the REAL classification, were retrieved from the pathologic reports. Immunoperoxidase stains for LMP-1 were performed on 40 cases.Results: The mean age of all cases was 26.7 years, with a median of 25 years. There were 36 males and 34 females. The largest age group was seen in 15 - 40 years accounting for 68.5%. The third decade took the peak incidence (21/70, 30%). Nodular sclerosis Hodgkin's lymphoma was the most common subtype representing 58.5% of all the cases, followed by mixed cellularity (37.2% of cases). The lymphocyte depleted subtypes in 2.8%, whereas lymphocytic predominant seen in 1.4% of cases.Latent membrane protein-1 was observed in 37.5% of Hodgkin's lymphoma. The most frequent association was observed in lymphocytic depletion subtype (50%), followed by mixed cellularity subtype (45%). The least frequent association was in nodular sclerosis type (27.7%). The highest rate of EBV expression was seen in the pediatric age group (< 15 years; 66.6%) and the lowest rate was among young adults (15-40 years; 26.9%). Older age group (> 40 years) has a rate of EBV expression (50%) which is higher than the young adult patients, but lower than the pediatric age group. Epstein-Barr virus positive cases were mostly males (73.3%) compared to females (26.7%). Conclusion: Hodgkin's lymphoma in our locality, in comparison with earlier studies, shows changing pattern with a gradual trend to those of developed countries including peak age group and subtypes. Moreover, Epstein-Barr virus is seen in slightly more than one third of cases and mostly seen in childhood, mixed cellularity and lymphocytic depletion subtypes with a male predominance.