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Objective: Epstein–Barr virus-positive diffuse large B-cell lymphoma is a provisional entity in the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues. Reports on the characteristics and clinical outcome of this disease in different geographic regions showed great disparities. Methods: To define the clinical characteristics as well as the prognostic impact of Epstein – Barr virus infection on diffuse large B-cell lymphoma in Taiwan, we retrospectively investigated the Epstein–B arr virus status of 89 patients with newly diagnosed diffuse large B-cell lymphoma in our institute. Results: Using a cutoff point of positive nuclear staining of Epstein–Barr virus-encoded RNA1-in situ hybridization in � 20% of the examined cells, we identified 15 cases (16.9%) of the entire study cohort as Epstein–B arr virus-positive diffuse large B-cell lymphoma. The clinical and laboratory features were not different between Epstein– Barr virus-positive and -negative diffuse large B-cell lymphoma patients. Univariate analysis showed patients with diffuse large B-cell lymphoma that were either Epstein–B arr virus-positive or had activated B-cell-like features had an inferior overall survival. Older age, advanced stage and lymphoma with activated B-cell-like features or Epstein–Barr virus-encoded RNA positivity were independent prognostic factors affecting overall survival on multivariate analysis. Patients with two or three of these adverse-risk factors were considered high risk and fared far worse than patients with no or only one adverse factor. Conclusions: Taken together, we demonstrated that a higher frequency of Epstein–Barr virus association was detected in a Taiwanese cohort of diffuse large B-cell lymphoma patients, and Epstein –B arr virus-encoded RNA positivity was shown to add important prognostic value in these patients.

Epstein-Barr virus–positive (EBV-positive) diffuse large B-cell lymphoma (DLBCL) of the elderly is a newly described lymphoproliferative disorder recently included as a “provisional” entity in the most current WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. The objective of this review is to provide a thorough and current summary of the existing knowledge of this subtype of DLBCL. We will review and discuss the incidence of EBV expression in DLBCL, the pathogenesis behind EBV-driven malignant transformation of B cells, the different EBV latency patterns associated with DLBCL, the distinct pathologic characteristics of EBV-positive DLBCL, the potential predictive and prognostic value of EBV tumoral status in patients with DLBCL, and potential strategies for the treatment of this rare entity, which is characterized by a suboptimal response to therapy and poor survival rate.

T/natural killer (NK)-cell lymphoma is a subtype of non-Hodgkin's lymphoma, with frequent cutaneous involvement; it follows an aggressive course. Most cases are reported in Asia, and typically present with nasopharyngeal involvement. There is a distinct variant known as blastoid T/NK-cell lymphoma, which affects elderly, non-Asian patients, with absence of nasal involvement. We report a middle-aged caucasian man who had blastoid T/NK-cell lymphoma with nasal involvement.