HHV-8-associated T-cell lymphoma in a lymph node with concurrent peritoneal effusion in an HIV-positive man.

Abstract

Primary effusion lymphoma (PEL) is an uncommon large cell lymphoma, usually seen in human immunodeficiency virus (HIV)-infected patients. PEL is characterized by various clinical, histomorphologic, and immunophenotypical features, and is associated with the human herpes virus 8 (HHV-8). PEL may present as either a body cavity-based lymphomatous effusion or a solid tumor mass. Most so-called "solid PEL" usually have an extranodal location; exceptionally rarely, they occur in lymph nodes. The majority of PEL consist of malignant cells of B-cell genotype; seldom they are of T-cell origin. We report a rare case of HHV-8-associated "solid PEL" of T-cell type in a 41-year-old HIV-seropositive man with a concomitant peritoneal effusion. The T-cell lymphoma was diagnosed on the basis of morphologic, immunophenotypic, and molecular findings of a lymph node biopsy. The tumor cells strongly expressed CD45R0, CD7, CD43, MUM1/IRF4, CD30, HHV-8, and EBER, and demonstrated a clonal rearrangement of T-cell receptor-gamma chain gene. The following case provides another example of a lymph node-based "solid" PEL, demonstrating the variety within the spectrum of HHV-8-associated lymphoma.