Primary effusion lymphoma-like lymphoma in a patient with inflammatory bowel disease.

[primary effusion lymphoma]

A 77 -year -old man with inflammatory bowel disease (IBD ) and who was treated with anti-tumor necrosis factor (TNF ), 6 -mercaptopurine and corticosteroids , presented with primary effusion lymphoma -like lymphoma (PEL -like lymphoma ) with massive ascites . The patient 's clinical course was complicated by acute renal insufficiency and hypotension , which led to death within 2 wk . In general , patients with IBD may have an increased risk for development of lymphoma , which is frequently associated with immunosuppressive and /or anti-TNF antibody therapies . PEL is a rare subset of lymphoma localized to serous body cavities , lacks tumor mass or nodal involvement , and is associated with infection by human herpes virus 8 (HHV-8 ). Primary neoplastic effusion may also be present in patients with large B-cell lymphoma without evidence of human immunodeficiency virus or HHV-8 infections . This type of lymphoma is classified as PEL -like lymphoma . Both PEL and PEL -like lymphoma types have been reported in patients undergoing immunosuppressive therapy , but to the best of our knowledge , the case described herein represents the first PEL -like lymphoma occurring in a patient with IBD .