Synchronous follicular lymphoma, kaposi sarcoma, and castleman's disease in a HIV-negative patient with EBV and HHV-8 coinfection.

Publisher: Sage Publications Country of Publication: United States NLM ID: 9314927 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-2465 (Electronic) Linking ISSN: 10668969 NLM ISO Abbreviation: Int J Surg Pathol Subsets: MEDLINE

Publication: Thousand Oaks, CA : Sage Publications
Original Publication: Naperville, IL : Churchill Livingstone, c1993-

Herpesvirus 8, Human*; Castleman Disease/*pathology ; Coinfection/*pathology ; Epstein-Barr Virus Infections/*complications ; Lymphoma, Follicular/*virology ; Neoplasms, Multiple Primary/*virology ; Sarcoma, Kaposi/*virology; Aged ; Castleman Disease/complications ; Castleman Disease/virology ; Diabetes Mellitus, Type 2/complications ; Female ; Flow Cytometry ; Gastritis/complications ; Humans ; Lymphoma, Follicular/pathology ; Neoplasms, Multiple Primary/pathology ; Pancreatitis/complications ; Polymerase Chain Reaction ; Sarcoma, Kaposi/pathology

The authors describe the case of a 65-year-old woman who was HIV negative and had a lymph node biopsy that showed concurrent follicular lymphoma (FL; grade 3A), Kaposi sarcoma (KS), and Castleman's disease (CD) with coinfection by human herpes virus-8 (HHV-8) and Epstein-Barr virus (EBV). The lymphoma was positive for CD20, CD10, and BCL6 and negative for BCL2. Flow cytometry showed a clonal lambda B-cell population, and polymerase chain reaction (PCR) showed a clonal immunoglobulin heavy chain gene rearrangement, confirming a neoplastic B-cell process. Focally, the FL component showed numerous EBER1-positive cells, with rare HHV-8-positive cells. The KS component showed strong HHV-8 expression with rare EBER1-positive cells. The CD component showed scattered HHV-8, viral interleukin-6, and EBER1-positive cells. The simultaneous occurrence of a FL, KS, and CD in an HIV-negative patient expands the spectrum of HHV-8-positive neoplasms and suggests the possibility of HHV-8 rendering mature B-cells hyperresponsive to antigenic stimulation, providing an expanded target for second site mutations or cytokine-driven hyperplasia, culminating in lymphoma.

Date Created: 20090808 Date Completed: 20120307 Latest Revision: 20171116

20240829

10.1177/1066896909341803

19661098