title: Kaposi sarcoma-associated herpesvirus in non-Hodgkin lymphoma and reactive lymphadenopathy in Uganda.
abstract: Kaposi sarcoma-associated herpesvirus (KSHV) causes Kaposi sarcoma and is also associated with primary effusion lymphoma, a subset of diffuse large B-cell lymphomas, and multicentric Castleman disease. Because KSHV infection is endemic in sub-Saharan Africa, we sought to identify cases of KSHV-positive non-Hodgkin lymphomas (NHLs) and reactive lymphadenopathy in this region. One hundred forty-four cases (80 NHLs, 64 reactive lymph nodes) from the major pathology laboratory in Uganda were reviewed. One NHL was KSHV-positive, as indicated by staining for the viral latent nuclear antigen. This NHL was a diffuse large B-cell lymphoma in a 5-year-old boy. The tumor was also Epstein-Barr virus-positive. In addition, 2 reactive lymph nodes, both classified histologically as follicular involution, stained KSHV latent nuclear antigen-positive and thus most likely represent multicentric Castleman disease. In all 3 KSHV-positive cases, a minority of cells expressed KSHV viral interleukin 6, a biologically active cytokine homolog. In conclusion, we show that KSHV is rarely associated with lymphoproliferative disorders in sub-Saharan Africa. We describe the first case of a KSHV-positive NHL from this region; this case is also the first reported pediatric lymphoma associated with KSHV infection.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD 20892, USA. engelse@exchange.nih.gov
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
authors.forename: Sam M
authors.initials: SM
authors.lastname: Mbulaiteye
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Othieno
authors.forename: Mario
authors.initials: M
authors.lastname: Gomez
authors.forename: Susan
authors.initials: S
authors.lastname: Mathew
authors.forename: Ethel
authors.initials: E
authors.lastname: Cesarman
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Knowles
authors.forename: Amy
authors.initials: A
authors.lastname: Chadburn
mesh_terms: D000956:Antigens, Viral / Q000032:analysis; D002675:Child, Preschool; D020031:Epstein-Barr Virus Infections / Q000473:pathology / Q000821:virology; D004854:Herpesvirus 4, Human / Q000235:genetics; D019288:Herpesvirus 8, Human / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008206:Lymphatic Diseases / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000473:pathology / Q000821:virology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology* / Q000821:virology; D008297:Male; D009687:Nuclear Proteins / Q000032:analysis; D012514:Sarcoma, Kaposi / Q000473:pathology* / Q000821:virology; D014454:Uganda
chemical_list: D000956:Antigens, Viral; D009687:Nuclear Proteins; C109540:latency-associated nuclear antigen