Epstein-Barr Virus Expression in Hodgkin's Lymphoma in Kuwait


Department of Pathology, Faculty of Medicine, Kuwait University, Portland, USA


The epidemiology of Hodgkin's lymphoma (HL) shows wide geographic variation in histological subtypes and in its association with the Epstein-Barr virus (EBV). The proportion of EBV positive HL is low in industrialized countries, high in non-industrialized countries and intermediate in early-industrialized countries. Reports from the Persian Gulf and Middle East are very limited. The aim of this study was to determine the epidemiology of HL in Kuwait, an early-industrialized country in the Persian Gulf, and to delineate the extent of its association with EBV. We reviewed 134 cases of HL for histological classification and demographic data. 107 cases were examined for the presence of EBV using immunohistochemistry (IHC) for the latent membrane protein I (LMPI) and in-situ hybridization (ISH) for EBVencoded RNA (EBER). 70.4% of the patients were males and 29.6% were females. The male: female ratio was 2.4:1. The mean age was 30.6 years (range, 4-71 years). Mixed cellularity HL (MCHL) was the most common subtype (45.5%), followed by nodular sclerosis (37.3%), nodular lymphocyte predominant (6.7%), lymphocyte rich (3%) and lymphocyte depletion (3%). 4.5% of cases were unclassifiable. EBV expression was seen in 56%, was significantly higher in MCHL, in children, and in males. Our findings suggest that the frequency of EBV expression in HL in Kuwait is similar to other early-industrialized countries. Further research from other countries in the Persian Gulf and the Middle East should shed more light on the epidemiology of HL and its relation to EBV in this region. Pathology & Oncology Research, Vol 9, Nr 3, 159-165, 2003

Key words: Hodgkin's lymphoma; Epstein Barr virus; in situ hybridization; Epstein Barr virus encoded RNA; immunohistochemistry; Epstein Barr virus latent membrane protein 1

Received: Jun 6, 2003; accepted: Aug 25, 2003
Correspondence: R R MAKAR, Department of Pathology, Faculty of Medicine, Kuwait University, 1330 SW Third Avenue #1210 Portland OR 97201, USA; Tel: 1-503-274-2033; E-mail:

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