SIMULTANEOUS ONSET OF PRIMARY CUTANEOUS B-CELL LYMPHOMA AND HUMAN HERPESVIRUS 8-ASSOCIATED KAPOSIS-SARCOMA

We report the simultaneous occurrence of Kaposi's sarcoma (KS) and pri mary cutaneous B-cell lymphoma (CBCL) of the leg in a 79-year-old woma n, seronegative for I-W-I, HTLV-1 and HTLV-2. The CBCL underwent compl ete clinical remission after local radiotherapy, whilst the KS became disseminated within a year following diagnosis. However, 2 years after the diagnosis of KS, the patient died with neurological symptoms, The se were presumed to be due to involvement of the central nervous syste m by lymphoma, although in the absence of an autopsy, this could not: be proven. Skin biopsies from the original KS and CBCL lesions, as wel l as short-term culture of spindle cells from the KS lesion and periph eral blood mononuclear cells (PBMC), were studied by semiquantitative polymerase chain reaction (PCR) using primers specific for DNA sequenc es of a novel gamma-herpesvirus-8 (HHV-8). PCR studies were strongly p ositive for the virus on KS cells and PBMC; conversely, a low viral lo ad was found on CBCL cells. A high titre of serum IgG antibodies react ing with the nuclei of the HHV-8 positive cell line BCP-1 was found. T hese data suggest that reactivation of latent infection with HHV-8 had occurred in this patient, and that HHV-8 is directly involved in KS, but not in CBCL of the leg, an aggressive variant of CBCL.