Primary effusion lymphoma after heart transplantation: a new entity associated with human herpesvirus-8

Deep immunosuppression and Epstein-Barr virus (EBV) infection promote the e mergence of lymphoproliferative disorders in patients undergoing solid orga n transplantation. In the last few years a new herpesvirus, named human her pesvirus-8 (HHV-8), has been identified in Kaposi's sarcoma and primary eff usion lymphoma (PEL) developing in AIDS patients. Subsequently, the same vi ral DNA sequences have been identified in almost all cases of Kaposi's sarc oma emerged outside HIV infection, thus suggesting their possible pathogene tic role in this tumor. Similarly, the association between HHV-8 and PEL al so emerged in cases without HIV infection, even though the total number of these patients is still limited. Here, we focus on the emergence of this un usual lymphoma in patients undergoing solid organ transplant and underline once again its association with the HHV-8. Moreover, despite the characteri stic local growth of this peculiar type of lymphoma, we demonstrate at the molecular level, an early neoplastic spread to the bone marrow suggesting t he need to investigate in more detail the origin of the disease, as well as the molecular mechanisms controlling its systemic dissemination.