Human herpes virus-8 associated primary effusion lymphoma of the pleural cavity in HIV-negative elderly men

Human herpes virus-8 (HHV-8)-associated primary effusion lymphoma (PEL) is an unusual lymphoma confined to the body cavities, which primarily affects human immunodeficiency virus (HIV)-positive men at high risk for Kaposi's s arcoma (KS), We describe two HIV-negative elderly Italian men, who develope d pleural HHV-8-positive PEL in association with other diseases (systemic h ypertension, colonic carcinoma, chronic obstructive airways disease, dilate d cardiomyopathy), but without KS. Thoracic computed tomography revealed un ilateral pleural effusion and pleural thickening, Thoracentesis disclosed l arge lymphoma cells, with no T- or B-cell associated antigens, clonal rearr angement of the immunoglobulin heavy chain gene and the presence of HHV-8 b ut not Epstein-Barr virus deoxyribonucleic acid sequences. Our cases differ from most pleural effusion lymphomas, in that they are non -acquired immunodeficiency syndrome-related. This highlights the possible h uman herpes virus-8-associated primary effusion lymphoma risk among elderly human immunodeficiency virus-negative patients, particularly Italians, in whom human herpes virus-8 seroprevalence rates and incidence of classic Kap osi's sarcoma are high.