Presence of human herpesvirus 8 DNA sequences in renal transplantation-associated pleural Kaposi sarcoma.
OBJECTIVE
To describe one case of symptomatic skin and pleural Kaposi sarcoma (KS) associated with kidney transplantation. Diagnosis was supported by morphologic study and human herpesvirus 8 (HHV-8) detection in both tissues. Pulmonary involvement was not present.


METHODS
The presence of HHV-8 DNA sequences was proved using polymerase chain reaction (PCR), Southern blot hybridization, and in situ hybridization.


METHODS
Human herpesvirus 8 is found in most KS from patients with and without the acquired immunodeficiency syndrome. Clinically significant pulmonary infiltration by KS is diagnosed uncommonly antemortem, and pleural disease is exceptional.


METHODS
A 49-year-old man who had renal transplant with immunosuppressive therapy (tacrolimus and prednisone) and developed a cutaneous KS. A pleural effusion appeared without pulmonary involvement. Both lesions disappeared when immunosuppressive drugs were suspended. Later, the pleural effusion and the cutaneous lesions reappeared. Pleural biopsy specimens showed KS infiltration.


RESULTS
The patient refused treatment and was lost to follow-up.


RESULTS
The skin and pleural biopsies showed a proliferation of spindle-shaped cells positive for CD34. The HHV-8 sequences were detected by nested PCR. No amplification was detected in uninvolved skin from the patient or in peripheral blood mononuclear cells from 10 healthy individuals used as controls. The Southern blot hybridization confirmed these results.


CONCLUSIONS
To our knowledge, this is the first report of HHV-8 in symptomatic pleural KS, which was probably associated with immunosuppression after kidney transplantation. The demonstration of HHV-8 DNA in biopsy material in the appropriate cells could be diagnostic when the morphologic setting is consistent with KS.
Gómez-Román
J J
JJ
Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Instituto Nacional de la Salud, Medical Faculty, University of Catabria, Santander, Spain.
Ocejo-Vinyals
J G
JG
Sánchez-Velasco
P
P
Leyva-Cobián
F
F
Val-Bernal
J F
JF
D015139:Blotting, Southern; D004279:DNA, Viral / Q000032:analysis*; D019288:Herpesvirus 8, Human / Q000235:genetics*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D017403:In Situ Hybridization; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000209:etiology / Q000473:pathology / Q000821:virology*; D016133:Polymerase Chain Reaction; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000473:pathology / Q000821:virology*; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology / Q000821:virology
D004279:DNA, Viral