Epstein-Barr virus-positive multiple early gastric cancers and dysplastic lesions: a case report.

Abstract:

:Epstein-Barr virus (EBV) has been implicated as a causal virus of gastric cancer with episomal monoclonality, elevated antibodies and a unique morphologic expression in the early intramucosal stage, but the infection mechanisms have not been demonstrated. EBV has been shown only in the cancerous lesions by the highly sensitive EBV-encoded small RNA in situ hybridization (EBER-ISH) method, not in the dysplastic mucosa adjacent to the cancer. A case is presented of multiple EBV-positive gastric cancer and dysplastic epithelium observed in a 52-year-old man. Serial cut sections of the gastrectomy specimen showed four small cancerous lesions, three of which were EBER-positive, and three EBER-positive, minute, non-cancerous dysplastic lesions. The three cancerous lesions were intramucosal cancer, with one having minimal submucosal invasion forming a lymphoepithelioma-like histology. All of these EBER-positive cancerous and dysplastic lesions showed intense CD8 T-lymphocytic infiltration. There was no such findings in the EBV-negative cancerous lesion. It was concluded that EBV infection may occur in the epithelial cells of atrophic gastric mucosa, and progress to cancer with monoclonal expansion through the EBV-positive dysplastic change. Cytotoxic T-lymphocytic reactions can occur even in the dysplastic lesions. Multifocal EBV infection in the gastric mucosa may occur and, if necessary, total gastrectomy is recommended in such a case.

journal_name

Pathol Int

journal_title

Pathology international

authors

Arikawa J,Tokunaga M,Tashiro Y,Tanaka S,Sato E,Haraguchi K,Yamamoto A,Toyohira O,Tsuchimochi A

doi

10.1111/j.1440-1827.1997.tb04450.x

subject

Has Abstract

pub_date

1997-10-01 00:00:00

pages

730-4

issue

10

eissn

1320-5463

issn

1440-1827

journal_volume

47

pub_type

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