| [ Summary ] |
Clinical, epidemiological and molecular pathological evidence showed that HCV infection may be involved in the pathogenesis of B-cell lymphoid neoplasms such as B cell non-Hodgkin's lymphoma and Waldenstrom's macroglobuiinemia. The prevalence of HCV infections in B cell non-Hodgkin's lymphoma is higher (10 to 30%), than in the general population or those with other hematological malignancies. HCV-related lymphoma tends to involve extranodal sites, such as the liver, the salivary gland, or the spleen. The most common histological subtypes of lymphoma associated with HCV infection were reported to be immunocytoma or diffuse large cell type (REAL classification). Although cryoglobulinemia has been proposed to be an expression of lymphoproliferative diseases in HCV-infected patients, the association with HCV-related lymphoma seems less prominent in Japanese cases. The development of lymphoma does not seem to corrclate with other clinical features, including the extent of liver dysfunction or HCV genotypes. Clonal B cell expansion was demonstrated in peripheral blood, bone marrow and liver of HCV-infected paticnts. However, whether the proliferating B cell population may become the clonal origin of the lymphoma is unknown, and etiological role of HCV in the generation and the evolution of neoplastic proliferation is yet to be established. |