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Epstein-Barr virus-positive nodular lymphocyte predominant Hodgkin lymphoma.
[hodgkin lymphoma, classical]
Hodgkin
lymphoma
(
HL
)
is
classified
into
2
largely
distinct
subgroups
,
namely
nodular
lymphocyte
predominant
HL
(
NLPHL
)
and
classic
HL
(
CHL
)
.
CHL
is
further
divided
into
nodular
sclerosis
,
lymphocyte-rich
,
mixed
cellularity
(
MCCHL
)
and
lymphocyte-depleted
(
LDCHL
)
subtypes
.
In
industrialized
nations
,
Epstein-
Barr
virus
(
EBV
)
has
been
associated
with
all
types
of
CHL
,
especially
the
MCCHL
and
LDCHL
subtypes
,
but
is
rare
in
NLPHL
.
We
report
8
cases
of
EBV-
positive
NLPHL
occurring
in
patients
in
the
United
States
.
All
8
patients
have
no
history
of
immunosuppression
and
presented
with
localized
or
systemic
lymphadenopathy
.
Histologically
,
6
cases
had
a
vaguely
nodular
pattern
and
2
cases
had
a
nodular
and
diffuse
pattern
.
In
all
cases
,
lymphocyte
predominant
(
LP
)
cells
were
observed
in
a
background
of
small
lymphocytes
and
histiocytes
.
Immunohistochemical
analysis
showed
that
the
LP
cells
in
all
cases
were
positive
for
CD
2
0
,
CD
7
9
a
,
PAX
5
,
OCT
2
,
and
CD
4
5
and
were
negative
for
CD
15
.
CD
30
was
expressed
variably
in
7
cases
.
EBV
encoded
RNA
was
present
in
all
LP
cells
in
5
cases
and
in
a
subset
of
LP
cells
in
3
cases
.
One
patient
was
treated
with
radiation
therapy
and
7
patients
received
chemotherapy
,
including
4
of
7
patients
who
underwent
autologous
stem
cell
transplantation
.
EBV
infection
is
a
rare
primary
or
secondary
event
in
NLPHL
that
correlates
with
poorer
prognosis
and
often
requires
more
aggressive
therapy
.
The
variable
expression
of
CD
30
in
most
of
these
cases
could
be
the
result
of
EBV
infection
.
Diseases
Validation
Diseases presenting
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated