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Nasal natural killer/T-cell lymphoma and its association with type "i"/XhoI loss strain Epstein–Barr virus in Chile

¹ Department of Medicine, Hematology Section, Faculty of Medicine, Universidad de Chile, Hospital Salvador, Santiago, Chile
² Division of Oncogenic and Persistent Viruses, Center for Chronic Viral Diseases, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
³ Kaisei-en, Geriatric Heatlth Services Facility, Kagoshima, Japan
⁴ Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
⁵ Department of Anatomia Pathologica, Imakiire General Hospital, Kagoshima, Japan
⁶ Department of Anatomia Pathologica, Hospital Salvador, Santiago, Chile
⁷ Department of Pathology, Pontificia Universidad Catolica de Chile, Santiago, Chile

Correspondence to:
Dr M E Cabrera
Hematology Section, Department of Medicine, Faculty of Medicine, University of Chile, Hospital Salvador, Av Salvador 364, Santiago SCL 133202, Chile; mecabrera{at}vtr.net Background: Nasal T/natural killer (NK)-cell lymphoma is an aggressive type of non-Hodking’s lymphoma associated with Epstein–Barr virus (EBV) and striking geographical variations worldwide.

Aim: To characterise nasal NK/T-cell lymphoma associated with genotypes of EBV in Chile, a Latin American country, where multiple strains of EBV, including two new recombinant strains, in healthy individuals were recently found.

Methods: Cases with diagnosis of primary nasal lymphoma were selected for histological and immunohistochemical analysis (CD3, CD3e, CD4, CD8, CD79a, CD56, CD57 and TIA-1) and in-situ hybridisation, serology and genotyping analysis for EBV.

Results: Out of 22 cases, 9 (41%) cases fulfilled the World Health Organization criteria for nasal NK/T-cell lymphoma; of these 7 (78%) cases were positive for EBV. Genotyping analysis revealed 6 cases of type 1 EBV and wildtype F at the BamHI-F region, 4 cases type "i" EBV at the BamHI-W1/I1 region; XhoI wild type was found in 2 and XhoI loss in 4 cases, respectively. Cosegregation analysis of the BamHI-W1/I1 region and XhoI restriction site showed the new recombinant strain type "i"/XhoI loss in 3 cases and type "i"/XhoI wild-type strain in 1 case. Most patients were treated with combined anthracycline-containing regimens. Half of the cases attained complete remission.

Conclusion: Although nasal NK/T-cell lymphomas from Chile share similar clinicopathological features, high association with EBV and unfavourable prognosis with those described elsewhere, genotype analysis shows that the new recombinant type "i"/XhoI loss strain might contribute to explain the intermediate incidence of nasal NK/T-cell lymphomas in Latin America.