Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses

Dylan V Miller; Dennis J Firchau; Rebecca F McClure; Paul J Kurtin; Andrew L Feldman

doi:10.1097/PAS.0b013e3181ce9128

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Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses

Journal article

Peer reviewed

Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses

Dylan V Miller, Dennis J Firchau, Rebecca F McClure, Paul J Kurtin and Andrew L Feldman

The American journal of surgical pathology, Vol.34(3), pp.377-384

03/2010

DOI: 10.1097/PAS.0b013e3181ce9128

PMID: 20139760

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Abstract

Primary cardiac lymphoma is extremely rare and lymphoma arising in association with prosthetic valves has been described in only 3 case reports. We describe 3 patients with diffuse large B-cell lymphoma (DLBCL) involving prosthetic heart valves and a synthetic tube graft. All 3 specimens showed shallow layering of acellular fibrinous debris over the prosthetic or synthetic materials, with tumor lymphocytes present at the luminal surface. There were frequent mitoses and abundant karyorrhectic debris. All demonstrated a nongerminal center B-cell phenotype. All 3 cases were positive for Epstein-Barr virus, but there was no staining for human herpes virus 8. There was no other evidence of distant disease at the time of diagnosis and no recurrence or dissemination occurred after surgical removal of the prosthesis, though follow-up was limited. On the basis of 2008 World Health Organization diagnostic criteria, we believe these cases should be classified as DLBCL associated with chronic inflammation. However, unlike the characteristically poor prognosis reported in this entity, we hypothesize that the disease resectability in these cardiac sites, in many cases, may allow for a better prognosis than DLBCL with chronic inflammation at other less resectable sites.

Heart Neoplasms - pathology

Device Removal

Heart Valve Prosthesis Implantation - instrumentation

Humans

Middle Aged

Heart Neoplasms - diagnostic imaging

Male

Tomography, X-Ray Computed

Blood Vessel Prosthesis

Prosthesis Design

Herpesvirus 4, Human - isolation & purification

Lymphoma, Large B-Cell, Diffuse - diagnostic imaging

Blood Vessel Prosthesis Implantation - adverse effects

Fatal Outcome

Aged, 80 and over

Female

Reoperation

Lymphoma, Large B-Cell, Diffuse - surgery

Lymphoma, Large B-Cell, Diffuse - pathology

Blood Vessel Prosthesis Implantation - instrumentation

Heart Valve Prosthesis

Heart Neoplasms - virology

Treatment Outcome

Lymphoma, Large B-Cell, Diffuse - virology

Heart Neoplasms - surgery

Heart Valve Prosthesis Implantation - adverse effects

Aged

Neoplasm Staging

Details

Title: Subtitle: Epstein-Barr virus-associated diffuse large B-cell lymphoma arising on cardiac prostheses
Creators: Dylan V Miller - Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USa. dylan.miller@imail.org
Dennis J Firchau
Rebecca F McClure
Paul J Kurtin
Andrew L Feldman
Resource Type: Journal article
Publication Details: The American journal of surgical pathology, Vol.34(3), pp.377-384
Publisher: United States
DOI: 10.1097/PAS.0b013e3181ce9128
PMID: 20139760
ISSN: 0147-5185
eISSN: 1532-0979
Language: English
Date published: 03/2010
Academic Unit: Pathology
Record Identifier: 9984047685902771

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