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. 2013 Mar;30(1):67-71.
doi: 10.4274/tjh.53215. Epub 2013 Mar 5.

Human Immunodeficiency Virus (HIV)-Negative and Human Herpes Virus-8 (HHV-8)-Positive Primary Effusion Lymphoma: A Case Report and Review of the Literature

Sonay Güven Karataş  1 , Reyhan Bayrak  2 , Ozlem Sahin Balçık  3 , Kadir Serkan Yalçın  1 , Esra Atıcı  1 , Umit Akyıldız  1 , Ali Koşar  3
Affiliations

Human Immunodeficiency Virus (HIV)-Negative and Human Herpes Virus-8 (HHV-8)-Positive Primary Effusion Lymphoma: A Case Report and Review of the Literature

Sonay Güven Karataş et al. Turk J Haematol. 2013 Mar.

Abstract
in English, Turkish

Primary effusion lymphoma (PEL) is a rare type of non-Hodgkin lymphoma that presents with serosal effusion in body cavities, without obvious tumor masses. Although PEL occurs in immunocompromised patients that are human immunodeficiency virus (HIV) positive, it also occurs in immunocompetent human herpes virus-8 (HHV-8)-positive patients. Herein we present an immunocompetent, HIV-negative, CD-20-negative, HHV-8-positive patient with pleural effusion that was diagnosed as PEL. The CHOP protocol and talc pleurodesis were administered. HHV-8 plays a causative role in PEL and is important for differentiating PEL from other types of lymphoma. As such, in addition to pleurodesis antiviral treatment should be considered for optimal treatment outcome.

Conflict of interest: None declared.

Primer efüzyon lenfoması (PEL) vücut boşluklarındaki seröz zarlarda tümör kitlesi olmaksızın, sadece serozal effüzyonla karakterize, nadir görülen bir hodgkin dışı lenfomadır. PEL immünsupresif ve özellikle HIV pozitif olgularda görülmekle birlikte Human herpes virus-8 (HHV-8) pozitif immün sistemi sağlam olgularda da tespit edilmektedir. Bu olguda immünkompetan, HIV negatif, plevral effüzyonu olan HHV-8 pozitif, primer effüzyon lenfomalı erkek hasta sunulacaktır. HHV-8 pozitif CD-20 negatif PEL olgumuzda tedavide CHOP protokolü ve talk plörodezis uygulandı. HHV-8 pozitifliği PEL tanı ve ayırıcı tanısında önemli role sahiptir. Bu yüzden, PEL tedavisinde plörodezise ek olarak antiviral tedavinin uygulanmasıyla başarılı sonuçlar elde edilebileceği düşünülmektedir.

Keywords: Differential diagnosis; Human herpes virus-8; Human immunodeficiency virus (HIV); Pleural effusion; Primary effusion lymphoma.

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Figures

Figure 1
Figure 1. Chest X-ray and chest CT show a massive, left-sided pleural effusion.
Figure 2
Figure 2. A-F: Cytomorphology and immunophenotype of the PEL cells. Large, atypical lymphoid cells exhibit rounded nuclei, coarsely granular chromatin, and a moderate amount of cytoplasm. Apoptotic bodies and necrotic debris are seen throughout the smears. Many of the smudged, small nuclei represent pyknosis (individual cell necrosis-not small lymphocytes (H&E, 1000×) (A-F a. Mitotic figures were abundant (A). Expression of CD30 (B), CD138 (C), epithelial membrane antigen (EMA) (D), and HHV-8 (E) in tumor cells (immunoperoxidase, 1000×). Cytomorphology of the PEL cells in the smears of ascites specimen (F).
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