Early peripheral lymph node involvement of human herpesvirus 8-associated, body cavity-based lymphoma in a human immunodeficiency virus-negative patient

Arch Pathol Lab Med. 2000 May;124(5):753-5. doi: 10.5858/2000-124-0753-EPLNIO.


Human herpesvirus 8 (HHV-8), or Kaposi sarcoma-associated herpesvirus, is a gamma herpesvirus first detected in a specimen of Kaposi sarcoma from a human immunodeficiency virus (HIV)-positive patient. Human herpesvirus 8 is also found in an unusual clinicopathologic form of body cavity-based B-cell lymphoma, which has been named primary effusion lymphoma (PEL) and occurs primarily in HIV-positive patients. PEL is characterized by the formation of lymphomatous effusions, without obvious lymphadenopathy, tumor masses, or bone marrow involvement. Only a few cases of PEL in HIV-seronegative patients have been reported. We describe a case of an HHV-8-associated lymphoma, with ascites, pleural effusion, and axillary lymphadenopathy in an HIV-negative patient. The patient was a 68-year-old Jewish man of North African extraction, with a previous history of coronary bypass surgery and multiple blood transfusions. The pleural fluid contained large atypical lymphoid cells and was suggestive of lymphoma but could not provide a conclusive diagnosis of PEL. The lymph node contained groups of large anaplastic lymphoid cells. Polymerase chain reaction for HHV-8 performed on the lymph node specimen was positive, establishing the diagnosis of PEL. Polymerase chain reaction for Epstein-Barr virus was negative. Results of a gallium scan were normal. The patient did not respond to combination chemotherapy with cyclophosphamide, doxorubicin, vincristine sulfate, and prednisone and progressively developed, massive intra-abdominal solid tumor formation. To our knowledge, this is the first report of a case of PEL that demonstrates peripheral lymph node involvement at diagnosis and the first report of PEL in an Israeli patient.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Axilla
  • Biopsy
  • Fatal Outcome
  • HIV Seronegativity*
  • Herpesvirus 8, Human / genetics
  • Herpesvirus 8, Human / isolation & purification*
  • Humans
  • Ki-1 Antigen / analysis
  • Lymph Nodes / pathology*
  • Lymphoma, B-Cell / drug therapy
  • Lymphoma, B-Cell / pathology*
  • Lymphoma, B-Cell / virology*
  • Male
  • Mucin-1 / analysis
  • Pleural Effusion, Malignant / diagnostic imaging
  • Pleural Effusion, Malignant / etiology
  • Polymerase Chain Reaction
  • Radiography


  • Ki-1 Antigen
  • Mucin-1