Hodgkin's disease and peripheral T-cell lymphoma: composite lymphoma with evidence of Epstein-Barr virus infection

This paper reports the case of a patient with a composite lymphoma consisting of nodular sclerosing Hodgkin's disease and peripheral T‐cell lymphoma. The Hodgkin and Reed–Sternberg (HRS) cells harboured the Epstein–Barr virus (EBV) and displayed a type II EBV latency (LMP1+/EBNA2−), whereas the neoplastic T‐cells were EBV‐negative. Four years later, the patient presented with a relapse of the peripheral T‐cell lymphoma. In situ hybridization revealed numerous EBV‐carrying lymphocytes, which were shown to be polyclonal B‐cells with a latency III pattern of EBV gene expression (LMP1+/EBNA2+). This observation suggests that impairment of EBV‐specific immunity in the micro‐environment of T‐cell lymphomas may facilitate the outgrowth of EBV‐carrying B‐lymphocytes and emphasizes the importance of determining the phenotype of EBV‐infected cells, particularly when studying T‐cell lymphomas. The results further suggest that the HRS cells and neoplastic T‐cells were of different clonal origins. The detection of EBV‐carrying cell populations admixed with the neoplastic T‐cells at primary presentation and at relapse raises the possibility that the growth of the T‐cell lymphoma was dependent on the presence of such cells. Copyright © 2000 John Wiley & Sons, Ltd.