A case of primary effusion lymphoma in an HIV-negative patient

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  • NAMBU Junichi
    Department of Diagnostic Pathology，Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center
  • NAKAZATO Iwao
    Department of Diagnostic Pathology，Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center
  • YAMAMURA Ikuko
    Department of Clinical Laboratory，Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center

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  • HIV 陰性患者に生じた原発性体腔液リンパ腫の 1 例

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Abstract

<p>Background : Primary effusion lymphoma (PEL) is a rare B-cell lymphoma that most often occurs in patients with human immunodeficiency virus (HIV) infection. Herein, we report a case of PEL in an HIV-negative patient.</p><p>Case : A 68-year-old man, living in Miyako islands of Okinawa prefecture, presented to a previous hospital with a history of dyspnea and right lumbar pain. CT revealed right pleural effusion, and the findings of pleural fluid cytology led to the suspicion of malignant lymphoma. The patient was then referred to and admitted at our hospital. Cytology repeated at our hospital showed large atypical cells with severe nuclear atypia. Immunohistochemical analysis of a cell-block specimen showed positive staining of the cells for CD30 and LANA-1, and negative staining for CD20. As no other tumor lesion was found on further work-up, we made the diagnosis of PEL. HIV antigen-antibody testing returned negative results.</p><p>Conclusion : PEL most often occurs in immunocompromised patients with HIV infection, and seldom in HIV-negative patients. Cases of PEL in immunocompetent elderly patients have been reported from geographical areas with a high prevalence of human herpesvirus type-8 (HHV8) infection, such as the Mediterranean region. Miyako islands, in Okinawa prefecture, are also known for a high prevalence of HHV8 infection. Hence, especially in patients from these areas, the possibility of PEL should be borne in mind when body fluid cytology in HIV-negative elderly individuals reveals large atypical lymphocytes.</p>

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