The Association of Epstein-Barr Virus With Plasma Cell Neoplasms

Plasma cell neoplasms (PCNs) refer to a group of true plasma cell disorders that include but are not limited to monoclonal gammopathy of undetermined significance (MGUS), plasmacytoma, and plasma cell myeloma (PCM). Epstein-Barr virus (EBV) expression has been reported in several hematopoietic and nonhematopoietic disorders. However, EBV expression in PCNs has been limited to severe immunodeficiency cases in the setting of post organ transplantation or HIV infection. The aim of this study is to evaluate the association of EBV with PCNs in both immunocompromised and immunocompetent patients. This retrospective study was performed on 141 formalin-fixed paraffin-embedded tissue samples on patients with PCNs (104 PCM, 21 plasmacytoma, and 16 MGUS). Six patients were immunocompromised. EBV-encoded RNA in situ hybridization (EBER-ISH) was performed with appropriate negative and positive controls. Decalcified tissue samples were excluded. EBER-ISH was positive in 6 cases. Two patients were HIV-positive (1 patient had plasmacytoma, and 1 patient had PCM). One patient was postrenal transplant with PCM. Three patients were immunocompetent (1 patient had PCM, and 2 patients had plasmacytoma). Our study is one of the largest studies to evaluate the association of EBV with PCNs. Our data shows that EBV has increased association with PCNs in the immunocompromised setting (3/6, 50%). However, EBV has low association with PCNs in the immunocompetent setting (3/135, 2.2%). EBER-ISH was positive in 1 of 100 (1.0%), 2 of 20 (10%), and 0 of 15 immunocompetent patients with PCM, plasmacytoma, and MGUS, respectively.