Diverse clinicopathologic features in human herpesvirus 8-associated lymphomas lead to diagnostic problems.
OBJECTIVE
Human herpesvirus 8 (HHV8)-associated lymphomas are uncommon, mainly affect men infected with the human immunodeficiency virus (HIV), and usually have a poor prognosis. We sought to characterize the HHV8+ lymphomas seen at our institution since the mid-1990s.


METHODS
We identified 15 patients with HHV8-associated lymphomas and evaluated their clinical and pathologic features.


RESULTS
Diagnoses included primary effusion lymphoma (PEL) (n = 2), extracavitary PEL (n = 8), intravascular large B-cell lymphoma (n = 1), HHV8+ plasmablastic microlymphoma (n = 3), and germinotropic lymphoproliferative disorder (GLD) (n = 1). The case of GLD progressed to a high-grade HHV8+ Epstein-Barr virus-positive lymphoma, an evolution that has not been previously reported. Four patients were HIV-(three from an HHV8-endemic area). Potentially misleading pathologic features in our series of extracavitary PEL included classic Hodgkin lymphoma-like features, lymph node sinus involvement, and T-cell antigen expression.


CONCLUSIONS
HHV8-associated lymphomas can be clinically and pathologically heterogeneous, with features that may lead to misdiagnosis as other types of lymphoma.
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA. ecourvil@umn.edu.
Elizabeth L
EL
Courville
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA.
Aliyah R
AR
Sohani
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA.
Robert P
RP
Hasserjian
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA.
Lawrence R
LR
Zukerberg
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA.
Nancy L
NL
Harris
From the James Homer Wright Pathology Laboratories of the Massachusetts General Hospital, the Department of Pathology, Harvard Medical School, Boston, MA.
Judith A
JA
Ferry
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications*; D019288:Herpesvirus 8, Human; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000821:virology*; D008297:Male; D008875:Middle Aged
Extracavitary primary effusion lymphoma; Germinotropic lymphoproliferative disorder; HHV8 lymphoma; Human herpesvirus 8; Multicentric Castleman disease; Plasmablastic microlymphoma; Primary effusion lymphoma