ORIGINAL ARTICLE

KSHV/HHV-8 associated lymph node based lymphomas in HIV seronegative subjects. Report of two cases with anaplastic large cell morphology and plasmablastic immunophenotype

A Carbone¹, A Gloghini², E Vaccher³, G Marchetti⁴, G Gaidano⁵ and U Tirelli⁶

¹ Department of Pathology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori, IRCCS, via Venezian 1, Milano I-20133, Italy
² Diagnostic Immunohistochemistry and Molecular Pathology Unit, Centro di Riferimento Oncologico, Istituto Nazionale Tumori
³ Department of Medical Oncology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori
⁴ Department of Pathology, Ospedali Riuniti - S. Chiara, Pisa I-56100, Italy
⁵ Hematology Unit, Department of Medical Sciences and IRCAD, "Amedeo Avogadro" University of Eastern Piedmont, Novara I-28100, Italy
⁶ Department of Medical Oncology, Centro di Riferimento Oncologico, Istituto Nazionale Tumori

Correspondence to:
Correspondence to:
Dr A Carbone
Department of Pathology, Istituto Nazionale Tumori, via Venezian 1, Milano I-20133, Italy; antonino.carbone{at}istitutotumori.mi.it

Background: Kaposi sarcoma associated herpesvirus (KSHV)/human herpesvirus 8 (HHV-8) associated lymphomas, which often develop in human immunodeficiency virus (HIV) infected patients with advanced AIDS, present predominantly as primary effusion lymphoma (PEL) or, less frequently, as "solid" extracavitary based lymphomas, associated with serous effusions. These last lymphomas, also called "solid PEL", have been reported before the development of an effusion lymphoma and after resolution of PEL. Interestingly, KSHV/HHV-8 associated lymphomas that present as solid or extracavitary based lesions in HIV seropositive patients without serous effusions have been reported recently.

Methods/Results: This paper provides evidence for the existence of a previously undescribed KSHV/HHV-8 associated lymphoma in HIV seronegative patients without serous effusions. These lymphomas exhibit a predilection for the lymph nodes and display anaplastic large cell morphology. These tumours were completely devoid of common cell type specific antigens, including epithelial and melanocytic cell markers. B and T cell associated antigens and other commonly used lymphoid markers were absent or weakly demonstrable in a fraction of the tumour cells. Conversely, immunohistochemical studies showed strong immunostaining with plasma cell reactive antibodies.

Conclusions: Analysis of viral infection and immunohistological studies are of primary importance to define this lymph node based KSHV/HHV-8 associated lymphoma with anaplastic large cell morphology and plasmablastic immunophenotype occurring in HIV seronegative patients without serous effusions.

Abbreviations: AQP3, aquaporin-3; CigG, cytoplasmic IgG; EBER, Epstein-Barr virus encoded small non-coding RNA; EBNA-1, Epstein-Barr virus nuclear antigen 1; EBV, Epstein-Barr virus; GRA, granzyme A; HHV-8, human herpesvirus 8; HIV, human immunodeficiency virus; ISH, in situ hybridisation; LMP, latent membrane protein; KSHV, Kaposi sarcoma associated herpesvirus; MCD, multicentric Castleman disease; ORF, open reading fragment; PEL, primary effusion lymphoma; SELPLG, selectin P ligand; VEGF, and vascular endothelial growth factor; vIL-6, viral interleukin 6

Keywords: lymphoma; KSHV/HHV8 associated lymphomas; anaplastic large cell lymphoma; plasmablastic lymphoma; diffuse large B cell lymphoma

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This article has been cited by other articles:

• Du, M-Q, Bacon, C M, Isaacson, P G (2007). Kaposi sarcoma-associated herpesvirus/human herpesvirus 8 and lymphoproliferative disorders. J. Clin. Pathol. 60: 1350-1357 [Abstract] [Full Text]