An unusual presentation of extracavitary primary effusion lymphoma

Genevieve M. Crane, Richard F Ambinder, Courtney M. Shirley, Elliot K Fishman, Yvette L. Kasamon, Janis M Taube, Michael J Borowitz, Amy S Duffield

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)426-432
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume38
Issue number3
DOIs
StatePublished - Mar 2014

Fingerprint

Primary Effusion Lymphoma
Human Herpesvirus 8
Lymphoma
Subcutaneous Fat
Human Herpesvirus 4
Biopsy
T-Lymphocytes
Skin
Sweat
Pelvis
Abdomen
Abdominal Pain
In Situ Hybridization
Weight Loss
Diarrhea
Neoplasms
Thrombosis
B-Lymphocytes
Fever
Coloring Agents

Keywords

  • Epstein-Barr virus
  • human herpesvirus type-8
  • intravascular lymphoma
  • Kaposi sarcoma-associated herpesvirus
  • primary effusion lymphoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery
  • Medicine(all)

Cite this

An unusual presentation of extracavitary primary effusion lymphoma. / Crane, Genevieve M.; Ambinder, Richard F; Shirley, Courtney M.; Fishman, Elliot K; Kasamon, Yvette L.; Taube, Janis M; Borowitz, Michael J; Duffield, Amy S.

In: American Journal of Surgical Pathology, Vol. 38, No. 3, 03.2014, p. 426-432.

Research output: Contribution to journalArticle

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