MRI of benign hyperplasia in the nasopharynx: is there an association with Epstein–Barr virus?

• Published in: Clinical radiology Vol. 75; no. 9; pp. 711.e13 - 711.e18
• Main Authors: Ai, Q.-Y., King, A.D., So, T.Y., Lam, W.K.J., Mo, F.K.F., Tse, I.O.L., Woo, J.K.S., Chan, K.C.A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2020
• Subjects: Adult; Aged; DNA, Viral - analysis; Early Detection of Cancer - methods; Epstein-Barr Virus Infections - diagnosis; Epstein-Barr Virus Infections - virology; Female; Herpesvirus 4, Human - genetics; Humans; Hyperplasia - diagnosis; Magnetic Resonance Imaging - methods; Male; Middle Aged; Nasopharyngeal Neoplasms - diagnosis; Nasopharyngeal Neoplasms - virology; Nasopharynx - pathology; Nasopharynx - virology; Prospective Studies
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2020.05.011

To evaluate whether there is an association between persistently positive plasma Epstein–Barr virus (EBV) DNA and the presence and the change in benign hyperplasia. One hundred and seventeen participants with positive-plasma EBV-DNA, but without NPC from previous nasopharyngeal carcinoma (NPC) screening, underwent follow-up magnetic resonance imaging (MRI) and plasma EBV-DNA after 2 years. Logistic regression was used to analyse associations between MRI (benign hyperplasia on the follow-up MRI and change from 2 years earlier), and plasma EBV-DNA, smoking, and age. At follow-up, EBV-DNA positivity and smoking were independent parameters for the presence of benign hyperplasia (p=0.027 and 0.023 respectively). Compared with participants in whom EBV-DNA became negative (n=44/117 37.6%), those in whom EBV-DNA remained positive (n=73/117 62.4%) had a greater risk of benign hyperplasia developing (previous MRI normal), being stable or processing (52/73 71.2% versus 18/44 40.9%; p=0.001). These results suggest a potential link between benign hyperplasia on MRI and the EBV. As EBV contributes to NPC oncogenesis, future MRI research is warranted to determine if persistent benign hyperplasia is a risk marker for development of NPC. •Epstein-Barr virus (EBV) links with nasopharyngeal benign hyperplasia (NBH).•Latent EBV infection links with persistent presence of NBH.•Persistent NBH may be a risk marker for development of nasopharyngeal cancer.