BODY CAVITY-BASED MALIGNANT-LYMPHOMA CONTAINING KAPOSI SARCOMA-ASSOCIATED HERPESVIRUS IN AN HIV-NEGATIVE MAN WITH PREVIOUS KAPOSI-SARCOMA

Background: The role of Kaposi sarcoma-associated herpesvirus in the d evelopment of malignant lymphomas in patients negative for the human i mmunodeficiency virus (HIV) has not been established. Objective: To ex amine the possible role of Kaposi sarcoma-associated herpesvirus in a case of body cavity-based malignant lymphoma that occurred in an HIV-n egative patient who had previously had Kaposi sarcoma. Design: Case st udy. Setting: Academic medical center. Patient: A 94-year-old man with lymphomatous ascites. Measurements: Polymerase chain reaction (PCR) a nd Southern blot DNA analysis. Results: The body cavity-based lymphoma cells were positive for Kaposi sarcoma-associated herpesvirus by PCR and were negative for other herpesviruses, including Epstein-Barr viru s, cytomegalovirus, and human herpesviruses 6 and 7. Southern blot ana lysis of lymphoma DNA showed high levels of Kaposi sarcoma-associated herpesvirus (>40 to 80 genomes/cell). Clonal rearrangement of the immu noglobulin JH and JK genes was present, confirming the presence of a c lonal B-cell proliferation. Conclusions: Kaposi sarcoma-associated her pesvirus may be involved in the development of malignant lymphoma afte r Kaposi sarcoma in HIV-negative patients. This type of lymphoma, in c ontrast to body cavity-based lymphoma related to the acquired immunode ficiency syndrome, may have an indolent clinical course.