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Epstein Barr virus DNA analysis in blood predicts disease progression in a rare case of plasmablastic lymphoma with effusion.
[primary effusion lymphoma]
In
HIV-
1
-
infected
patients
a
long
lasting
CD
4
+
cell
decline
influences
the
host-
EBV
balance
and
thereby
increases
the
risk
for
EBV
related
malignancies
.
In
spite
of
a
world-
wide
access
to
combination
antiretroviral
therapy
(
cART
)
there
are
still
a
considerable
number
of
HIV-
1
-
infected
patients
who
will
develop
severe
immunodeficiency
.
These
undiagnosed
HIV-
1
infected
patients
,
so
called
late
testers
,
demonstrate
an
increased
lymphoma
risk
,
compared
to
patients
diagnosed
early
.
Consecutive
individual
screening
for
EBV
DNA-load
in
late
testers
might
be
a
useful
predictor
of
emerging
EBV-malignancy
.
Patient
biopsies
and
ascites
were
analyzed
morphologically
,
by
immuncyto-histochemistry
and
in
-situ
hybridization
.
Viral
DNA
and
RNA
load
were
quantified
by
PCR
.
Cell
lines
from
primary
tumor
and
from
ascites
,
were
established
in
vitro
and
further
analyzed
.
We
here
report
on
a
case
of
EBV-
positive
lymphoma
in
an
AIDS
patient
,
first
presenting
with
pleural
effusion
and
ascites
and
was
thus
initially
considered
a
primary
effusion
lymphoma
(
PEL
)
but
was
later
diagnosed
as
a
plasmablastic
lymphoma
(
PBL
)
.
The
patient
had
responded
to
cART
with
undetectable
HIV-RNA
and
increased
CD
4
cell
count
one
year
prior
to
lymphoma
presentation
.
At
the
time
of
lymphoma
diagnosis
the
HIV-RNA
values
were
<
50
RNA-copies
per
mL
blood
(
undetectable
)
and
the
CD
4
-
positive
cell
count
170
×
106
/
L
.
The
lymphoma
was
CD
4
5
-
negative
and
weakly
CD
22
-
and
CD
30
-
positive
.
The
patient
had
a
history
of
Kaposi
sarcoma
and
HHV-
8
seropositivity
.
The
lymphoma
biopsies
,
and
three
cell
lines
derived
on
different
occasions
from
the
tumor
cell
effusion
,
were
all
EBV-
positive
but
HHV-
8
negative
.
A
noticeable
EBV-DNA
load
decline
was
observed
during
the
remission
of
the
lymphoma
following
CHOP-therapy
.
The
EBV-DNA
load
increased
dramatically
at
the
time
of
recurrence
.
EBV
DNA
load
might
be
useful
in
monitoring
the
effect
of
lymphoma
treatment
as
well
as
in
estimating
the
risk
of
EBV-associated
lymphoma
in
HIV-
1
infected
patients
with
pronounced
immunosuppression
.
Diseases
Validation
Diseases presenting
"tumor cell effusion"
symptom
primary effusion lymphoma
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