AIDS-related body cavity-based lymphoma - A case report

BACKGROUND: Body cavity-based lymphomas are rare malignancies in human immu nodeficiency virus (HIV)-infected patients, but clinical, morphologic and i mmunophenotypic features, are recognized as a distinct subgroup of lymphoma s connected to human herpesvirus 8 (HHV-8) infection. CASE: A 39-year-old, HIV-positive, homosexual man was admitted to tile hosp ital because of a left-sided pleural effusion that contained malignant lymp hoid cells. He responded partially to a low-dose cyclophosphamide/ doxoruby cin/vincristine/prednisone regimen and died five months after the diagnosis of lymphoma. On cytology, the sediments contained exclusively large, round , neoplastic lymphoid cells with abundant basophilic cytoplasm and large, r ound nuclei with prominent nucleoli. Many cells had immunoblastic features, and some had plasmocytoid differentiation. Mitotic figures were numerous. On flow cytometry, the homogeneous population of large cells expressed CD45 , CD38, HLA-DX a,and CD7 positivity. Other specific T-, B- and NK-cell mark ers tested negative. Polymerase chain reaction demonstrated Epstein-Barr vi rus (EBV) and HHV-8 in the malignant effusion. CONCLUSION: Primary effusion from lymphoma with molecular evidence of HHV-8 and EBV coinfection represents a distinct clinical and morphologic entity in AIDS patients. However, immunophenotypic markers of malignant clones can be diverse in different cases.