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Oral solid form of primary effusion lymphoma mimicking plasmablastic lymphoma
José-Luis Mate1, José-Tomás Navarro, Aurelio Ariza
1Department of Pathology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
Insights
Primary effusion lymphoma (PEL), a rare cancer linked to HIV, can present unusually as a solid oral tumor. Identifying human herpesvirus 8 (HHV8) is key to diagnosing this rare PEL manifestation.
Area of Science:
- Oncology
- Virology
- Pathology
Background:
- Primary effusion lymphoma (PEL) is a rare, aggressive non-Hodgkin lymphoma.
- PEL is strongly associated with human immunodeficiency virus (HIV) infection.
- Human herpesvirus 8 (HHV8) is a key etiological factor in PEL development.
Observation:
- A case report of a 42-year-old HIV-positive male presenting with synchronous pleural effusion PEL and a tongue lesion.
- Both lesions exhibited plasmablastic morphology, posing a diagnostic challenge.
- The lingual lesion was unassociated with body cavity effusions, representing a rare solid form of PEL.
Findings:
- Immunohistochemical analysis confirmed HHV8 presence in the lingual lesion.
- This finding differentiated the oral lesion from plasmablastic lymphoma.
- The diagnosis of an oral solid form of PEL was established.
Implications:
- Highlights the importance of considering oral manifestations of PEL.
- Emphasizes the diagnostic utility of HHV8 testing in plasmablastic lymphomas, particularly in HIV-infected individuals.
- Underscores the need for comprehensive diagnostic workup in complex lymphoma cases.
Abstract:
Primary effusion lymphoma (PEL) is a rare large cell lymphoma subtype that usually is associated with human immunodeficiency virus infection. Features facilitating PEL identification are its clinical presentation, cytologic findings, immunophenotypic profile, and particularly, relation to human herpesvirus 8 (HHV8) infection. Uncommonly, PEL may present as a solid form that predominantly involves the distal digestive tract and poses major diagnostic problems, especially when unassociated with body cavity effusions. We herein report the case of an HIV-positive 42-year-old male with synchronous presentation of a pleural cavity PEL and a tongue-based lesion, both displaying plasmablastic features. Demonstration of HHV8 presence in the lingual lesion excluded a plasmablastic lymphoma and established the diagnosis of an oral solid form of PEL. This case illustrates the need for investigating HHV8 in any plasmablastic-looking lymphoma, especially in HIV-infected patients.