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KSHV/HHV-8 associated Kaposi’s sarcoma in lymph nodes concurrent with Epstein-Barr virus associated Hodgkin lymphoma

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: The unusual occurrence of a metastatic Kaposi’s sarcoma (KS) in a lymph node affected by Hodgkin lymphoma (HL) was originally reported when knowledge of the specific virological features of these tumours was lacking.

Aim: To re-evaluate this case by assessing whether the simultaneous presence of the two tumours was linked with common aetiopathogenetic factors.

Methods: The presence of EBV was investigated by in situ hybridisation, whereas KS associated herpesvirus (KSHV)/human herpesvirus 8 (HHV-8) was detected by immunohistochemistry. Both viruses were analysed in the case reported, in 30 lymph nodes from patients with classic HL, and in 22 skin biopsies from patients with KS.

Results: Consistent with the findings in the HL and KS cases analysed, in the case showing features of both HL and KS in the same lymph node, EBV was detectable only in Reed-Sternberg (RS) cells, but not in KS spindle cells, whereas KSHV/HHV-8 was detectable only in KS spindle cells, and not in RS cells.

Conclusion: It is probable that the development of KS and HL was related to two independent aetiological cofactors—KSHV/HHV-8 and EBV, respectively—and that the occurrence of the two malignancies in the same patient was merely fortuitous.

Abbreviations: EBV, Epstein-Barr virus; HHV-8, human herpesvirus 8; HIV, human immunodeficiency virus; HL, Hodgkin lymphoma; ISH, in situ hybridisation; KS, Kaposi’s sarcoma; KSHV, Kaposi’s sarcoma associated herpesvirus; ORF, open reading fragment; PEL, primary effusion lymphoma; RS, Reed-Sternberg

Keywords: Kaposi’s sarcoma; Hodgkin lymphoma; Kaposi’s sarcoma associated herpesvirus/human herpesvirus 8; Epstein-Barr virus; lymph node