Early peripheral lymph node involvement of human herpesvirus 8-associated,body cavity-based lymphoma in a human immunodeficiency virus-negative patient

Human herpesvirus 8 (HHV-8), or Kaposi sarcoma-associated herpesvirus, is a gamma herpesvirus first detected in a specimen of Kaposi sarcoma from a hu man immunodeficiency virus (HIV)-positive patient. Human herpesvirus 8 is a lso found in an unusual clinicopathologic form of body cavity-based B-cell lymphoma, which has been named primary effusion lymphoma (PEL) and occurs p rimarily in HIV-positive patients. PEL is characterized by the formation of lymphomatous effusions, without obvious lymphadenopathy, tumor masses, or bone marrow involvement. Only a Few cases of PEL in HIV-seronegative patien ts have been reported. We describe a case of an HHV-8-associated lymphoma, with ascites, pleural effusion, and axillary lymphadenopathy in an HIV-nega tive patient. The patient was a 68-year-old Jewish man of North African ext raction, with a previous history of coronary bypass surgery and multiple bl ood transfusions. The pleural fluid contained large atypical lymphoid cells and was suggestive of lymphoma but could not provide a conclusive diagnosi s of PEL. The lymph node contained groups of large anaplastic lymphoid cell s. Polymerase chain reaction for HHV-8 performed on the lymph node specimen was positive, establishing the diagnosis of PEL. Polymerase chain reaction for Epstein-Barr virus was negative. Results of a gallium scan were normal . The patient did not respond to combination chemotherapy with cyclophospha mide, doxorubicin, vincristine sulfate, and prednisone and progressively de veloped, massive intra-abdominal solid tumor formation. To our knowledge, t his is the first report of a case of PEL that demonstrates peripheral lymph node involvement at diagnosis and the first report of PEL in an Israeli pa tient.