Molecular Pathology - EBV

Question 1

Oral tumor with large fistula on hard palate

D/dx?

Answer 1

Nasal type NK-cell lymphoma***

Nasopharyngeal carcinoma (atypical)

Others: (rare)
Sinonasal undifferentiated carcinoma
Minor salivary gland carcinoma

Question 2

3 immediate Investigation methods for Oral tumor with large fistula on hard palate?

Answer 2

Biopsy of tumor in nasal cavity

Immunohistochemical test for CD56 and TIA-1

EBER In-situ hybridization for EBV infection

Question 3

Physiological function of CD3

Answer 3

Part of T-cell receptor complex

On T lymphocytes

Question 4

Physiological function of CD20

Answer 4

Glycosylated phosphoprotein on B-lymphocyte surface

Exact function unclear

Question 5

Physiological function of CD56

Answer 5

Neural cell adhesion molecule (NCAM)

Glycoprotein expressed on NK cells, neurons

Question 6

Physiological function of TIA-1

Answer 6

Cytotoxic granules in cytotoxic T cells and NK cells

Question 7

EBV:

• Genetic composition
• Family
• Acute disease and latency

Answer 7

Epstein-Barr virus

• Double stranded DNA virus
• Herpesviridae
• Acute = Infectious mononucleosis
• Latent in B-cells

Question 8

EBV:

• Difference in genetic structure in acute vs latent infection
• EBER structure, function

Answer 8

Acute = linear viral DNA 
Latent = circular (episomal)

EBER = EBV-encoded small RNAs
Isoforms: EBER1, EBER2
Non-coding RNA with unknown function
Carcinogenesis, high number for ISH

Question 9

Human cancers associated with EBV

- Immunocompetent

Answer 9

• Carcinomas:
  Nasopharyngeal
  Lymphoepithelial
  Gastric

- Lymphomas:
Burkitt 
Diffuse large B-cell 
Nasal NK-cell 
Hodgkin

Question 10

Human cancers associated with EBV

- Immunocompromised

Answer 10

Lymphomas: (not carcinomas)

High grade B-cell
Post-transplant lymphoproliferative disease

Question 11

Methods to detect EBV?

• samples
• Tests?

Answer 11

Tissue sample:

• Immunohistochemistry (IHC)
• In-situ hybridization *****

In serum/ plasma:

• Serum EBV DNA by qRT-PCR *****
• EBV viral capsid antigen (VCA) - IgA, IgG, IgM
• EBV early antigen IgA