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HHV-8-positive and EBV-positive intravascular lymphoma: an unusual presentation of extracavitary primary effusion lymphoma.
[primary effusion lymphoma]
Intravascular
lymphomas
are
rare
and
aggressive
hematolymphoid
tumors
.
Here
,
we
describe
a
human
herpesvirus
type
-
8
(
HHV-
8
)
/
Kaposi
sarcoma
-associated
herpesvirus-
positive
and
Epstein-
Barr
virus
(
EBV
)
-
positive
intravascular
lymphoma
.
The
patient
was
a
59
-
year
-old
human
immunodeficiency
virus-
positive
man
who
presented
with
diarrhea
,
abdominal
pain
,
fevers
,
night
sweats
,
and
weight
loss
.
Radiographic
studies
of
the
abdomen
and
pelvis
revealed
numerous
subcentimeter
nodules
within
the
subcutaneous
fat
that
lacked
connection
to
the
skin
.
An
excisional
biopsy
demonstrated
large
atypical
cells
within
vessels
in
the
deep
subcutaneous
fat
,
and
many
of
the
vessels
contained
extensive
organizing
thrombi
.
The
atypical
cells
lacked
strong
expression
of
most
B-
cell
markers
but
were
positive
for
MUM-
1
and
showed
partial
expression
of
several
T
-
cell
markers
.
An
immunohistochemical
stain
for
HHV-
8
and
an
in
situ
hybridization
for
EBV
were
both
positive
in
the
neoplastic
cells
.
The
disease
had
a
rapidly
progressive
and
fatal
course
.
This
lymphoma
appears
to
represent
an
entirely
intravascular
form
of
primary
effusion
lymphoma
and
highlights
the
propensity
for
HHV-
8
and
EBV-
positive
lymphoid
neoplasms
to
show
aberrant
expression
of
T
-
cell
markers
,
illustrates
the
utility
of
skin
biopsies
for
the
diagnosis
of
intravascular
lymphoma
,
and
suggests
that
biopsies
to
evaluate
for
intravascular
lymphoma
should
be
relatively
deep
and
include
subcutaneous
fat
.
Diseases
Validation
Diseases presenting
"and many of the vessels contained extensive organizing thrombi"
symptom
primary effusion lymphoma
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