Characterization of overt B-cell lymphomas in patients with hepatitis C virus infection

• Published in: Blood 1997-07, Vol.90 (2), p.776-782
• Main Authors: DE VITA, S, SACCO, C, ZAGONEL, V, SANSONNO, D, GLOGHINI, A, DAMMACCO, F, CROVATTO, M, SANTINI, G, DOLCETTI, R, BOIOCCHI, M, CARBONE, A
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antigens, CD - analysis; Autoimmune Diseases - immunology; Autoimmune Diseases - pathology; Autoimmune Diseases - virology; Biological and medical sciences; Cryoglobulinemia; Disease Susceptibility; Female; Hepatitis C - complications; Human viral diseases; Humans; Immunophenotyping; Infectious diseases; Italy; Lymphoma, B-Cell - immunology; Lymphoma, B-Cell - pathology; Lymphoma, B-Cell - virology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Sjogren's Syndrome - complications; Sjogren's Syndrome - epidemiology; Viral diseases; Viral hepatitis
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V90.2.776

A pathogenetic role of the hepatitis C virus (HCV) has been hypothesized for a subset of B-cell non-Hodgkin's lymphomas (NHLs). However, the preliminary characterization of B-cell NHLs in HCV-infected individuals has been poorly addressed. In the present study, we report detailed information on 35 consecutive patients with overt B-cell NHL of recent onset and HCV infection; all patients referred to a single oncological center in Northeast Italy. Histopathologic evaluation was performed by a single reference hemopathologist, and the link with the two relevant autoimmune diseases predisposing to B-cell NHL and in which HCV has been implied, ie, "essential" mixed cryoglobulinemia (EMC) and Sjogren's syndrome, was investigated. Control groups included 122 consecutive HCV-negative patients with B-cell NHL and 464 consecutive histopathologic cases of B-cell NHL referred to the same center, as well as 127 consecutive patients with HCV infection and without lymphoma referred to a different center in the same geographical area. B-cell NHLs in HCV-infected patients frequently presented at onset (1) an extranodal localization with peculiar target organs of HCV infection (ie, the liver and major salivary glands) being significantly overrepresented; (2) a diffuse large cell histotype without any prior history of low-grade B-cell malignancy or bone marrow involvement; and (3) a weak association with a full-blown predisposing autoimmune disease, although serum autoimmune features were common and cryoglobulins were always present. Therefore, the HCV-related B-cell NHLs in this oncological series presented distinctive features compared with B-cell NHLs in HCV-negative patients, and they differed from bone marrow low-grade NHLs frequently diagnosed in HCV-positive patients with EMC. Such novel information may be relevant for future research aimed at clarifying the possible link between HCV infection, autoimmunity, nonmalignant B-cell lymphoproliferation, and overt B-cell malignancy.