Tuberc Respir Dis.  2012 Dec;73(6):336-341. 10.4046/trd.2012.73.6.336.

A Case of Human Herpes Virus-8 Unrelated Primary Effusion Lymphoma-Like Lymphoma Presented as Pleural Effusion

• Kim KH
• Lee JH
• Jeong HC
• Kim GW
• Song SH
• Jung SY
• Kim GI
• Kim EK

• KMID: 1842928
• DOI: http://doi.org/10.4046/trd.2012.73.6.336

Abstract

Primary effusion lymphoma (PEL) is a rare type of lymphoma that arises in the body cavity without detectable masses. It is associated with human herpes virus-8 (HHV-8), Epstein-Barr virus (EBV), and human immunodeficiency virus (HIV). Recently, PEL unrelated to viral infection has been reported and it has been termed HHV-8 unrelated primary effusion lymphoma-like lymphoma (HHV-8 unrelated PEL-like lymphoma). Here, we report a case of HHV-8 unrelated PEL-like lymphoma in an 80-year-old woman. Chest X-ray and computed tomography revealed left-sided pleural effusion. Pleural effusion analysis and mediastinoscopic biopsy showed atypical cells that had originated from the B cells. The cells were positive for CD20 and bcl-2, but negative for CD3, CD5, CD21, CD30, CD138, epithelial membrane antigen, and HHV-8. Serological tests for HIV and EBV were negative. Considering the patient's age, further treatments were not performed. She has shown good prognosis without chemotherapy for more than 18 months.

Keyword

Lymphoma, Primary Effusion; Herpesvirus 8, Human; Pleural Effusion

MeSH Terms

B-Lymphocytes
Biopsy
Female
Herpesvirus 4, Human
Herpesvirus 8, Human
HIV
Humans
Lymphoma
Lymphoma, Primary Effusion
Mucin-1
Pleural Effusion
Prognosis
Serologic Tests
Thorax
Mucin-1

Figure

• 

  Figure 1 Chest X-ray (A, B) and computed tomography (C) at the time of admission showed left pleural effusion without evidence of pleural masses.

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  Figure 2 Positron emission tomography-computed tomography showed multiple focal strong fluorodeoxyglucose uptakes in mediastinal pleura adjacent to right upper lobe and right lower lobe, pretracheal node bearing areas.

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  Figure 3 (A) Thoracoscopic biopsy showed diffuse infiltration of large atypical lymphoid cells (H&E stain, ×200). (B) Pleural cytology showed many atypical lymphoid cells having medium to large nuclei and nucleoli. Frequent mitoses were found (Papanicolaou stain, ×200). (C~F) The tumor cells were positive for CD20. Immunohistochemistry showed CD20 (C), CD3 (D, negative), bcl-2 (E, positive), and Ki-67 (F, high-proliferating index) (×100).

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  Figure 4 Chest X-ray obtained 18 months after receiving diagnosis showed no pleural effusion.

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