Diverse clinicopathologic features in human herpesvirus 8-associated lymphomas lead to diagnostic problems

Am J Clin Pathol. 2014 Dec;142(6):816-29. doi: 10.1309/AJCPULI3W6WUGGPY.

Abstract

Objectives: Human herpesvirus 8 (HHV8)-associated lymphomas are uncommon, mainly affect men infected with the human immunodeficiency virus (HIV), and usually have a poor prognosis. We sought to characterize the HHV8+ lymphomas seen at our institution since the mid-1990s.

Methods: We identified 15 patients with HHV8-associated lymphomas and evaluated their clinical and pathologic features.

Results: Diagnoses included primary effusion lymphoma (PEL) (n = 2), extracavitary PEL (n = 8), intravascular large B-cell lymphoma (n = 1), HHV8+ plasmablastic microlymphoma (n = 3), and germinotropic lymphoproliferative disorder (GLD) (n = 1). The case of GLD progressed to a high-grade HHV8+ Epstein-Barr virus-positive lymphoma, an evolution that has not been previously reported. Four patients were HIV-(three from an HHV8-endemic area). Potentially misleading pathologic features in our series of extracavitary PEL included classic Hodgkin lymphoma-like features, lymph node sinus involvement, and T-cell antigen expression.

Conclusions: HHV8-associated lymphomas can be clinically and pathologically heterogeneous, with features that may lead to misdiagnosis as other types of lymphoma.

Keywords: Extracavitary primary effusion lymphoma; Germinotropic lymphoproliferative disorder; HHV8 lymphoma; Human herpesvirus 8; Multicentric Castleman disease; Plasmablastic microlymphoma; Primary effusion lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Herpesviridae Infections / complications*
  • Herpesvirus 8, Human
  • Humans
  • Lymphoma / diagnosis*
  • Lymphoma / virology*
  • Male
  • Middle Aged