We report a case of
composite lymphoma consisting of
peripheral T-cell lymphoma and an anaplastic variant of
diffuse large B-cell lymphoma (DLBCL) and associated with Epstein-Barr virus (
EBV) infection and strong p53 expression. A 65-year-old Japanese woman developed
fever and generalized
lymphadenopathy. A biopsy of the cervical node revealed the morphology of
malignant lymphoma with 2 kinds of
lymphoma coexisting in 1 lymph node. One
lymphoma type consisted of immunoblastic large cells with the T-cell marker phenotype CD3+, CD45RO/UCHL-1+, CD20/L26-, CD79-, CD10-, CD30-, and CD15-; the other type consisted of large cells with abundant cytoplasm and pleomorphic nuclei with the marker phenotype CD79+, CD20/L26+, CD45RO/UCHL-1-, CD3-, CD10-, CD30+,
NPM/ALK-, and CD15-. Therefore, the diagnosis was
composite lymphoma of
peripheral T-cell lymphoma and an anaplastic variant of DLBCL, stage IVB, because the patient had bone marrow involvement with
peripheral T-cell lymphoma. The biopsy led to findings of latent type II EBV-associated
lymphoma in both the
peripheral T-cell lymphoma and the anaplastic variant of DLBCL as the result of positive signals for EBV small RNAs by in situ hybridization, positive immunostaining results for EBV latent
membrane protein 1 antibody, and negative immunostaining results for
EBV nuclear antigen 2. Immunostaining of the mass with p53 antibody also yielded positive results for both types of
lymphoma cells. This case suggests that the immunocompromised state of this patient with EBV-related
peripheral T-cell lymphoma allowed the emergence of an EBV-related anaplastic variant of DLBCL and suggests a close relationship between p53 expression and latent
EBV infection.