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Primary effusion lymphoma involving three body cavities
Fadi Brimo1, Gizelle Popradi, René P Michel
1Department of Pathology, McGill University and McGill University Health Center, Montreal, Quebec, Canada. fadi.brimo@mail.mcgill.ca
Cytojournal
|October 31, 2009
Summary
Primary effusion lymphoma (PEL), a human herpes virus-8 (HHV8)-associated cancer, typically affects immunocompromised individuals. This case highlights PEL in an immunocompetent patient affecting multiple body cavities.
Area of Science:
- Oncology
- Virology
- Pathology
Background:
- Primary effusion lymphoma (PEL) is a rare, aggressive non-Hodgkin lymphoma.
- PEL is strongly associated with human herpes virus-8 (HHV8) infection.
- It typically manifests in body cavity effusions of immunocompromised individuals.
Observation:
- This report details a unique case of PEL in a 69-year-old immunocompetent patient.
- The patient presented with gastrointestinal bleeding and ascites, later involving pleural and pericardial cavities.
- Cytological examination revealed atypical lymphocytes with specific morphological features.
Findings:
- Neoplastic cells tested positive for HHV8 latent nuclear antigen (LNA) and Epstein-Barr virus-encoded RNA.
- Immunohistochemistry showed aberrant T-cell marker expression (CD3) alongside typical markers (CD45).
- Despite treatment, the disease progressed, leading to the patient's death within 5 months.
Implications:
- This case expands the clinical spectrum of PEL, demonstrating its occurrence in immunocompetent hosts and multifocal involvement.
- Accurate diagnosis hinges on HHV8 detection, differentiating PEL from other serous effusion lymphomas.
- Understanding PEL's diverse presentations is crucial for appropriate management and prognosis.
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