Body Cavity-Based Malignant Lymphoma Containing Kaposi Sarcoma-Associated Herpesvirus in an HIV-Negative Man with Previous Kaposi Sarcoma

  1. James A. Strauchen, MD;
  2. A. Daniel Hauser, MD;
  3. David Burstein, MD;
  4. Ricardo Jimenez, MD;
  5. Patrick S. Moore, MD; and
  6. Yuan Chang, MD
  1. From Mount Sinai School of Medicine and Columbia University College of Physicians and Surgeons, New York, New York. Requests for Reprints: James A. Strauchen, MD, Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029. Current Author Addresses: Drs. Strauchen, Burstein, and Jimenez: Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029.

    Abstract

    Background: The role of Kaposi sarcoma-associated herpesvirus in the development of malignant lymphomas in patients negative for the human immunodeficiency virus (HIV) has not been established.

    Objective: To examine the possible role of Kaposi sarcoma-associated herpesvirus in a case of body cavity-based malignant lymphoma that occurred in an HIV-negative patient who had previously had Kaposi sarcoma.

    Design: Case study.

    Setting: Academic medical center.

    Patient: A 94-year-old man with lymphomatous ascites.

    Measurements: Polymerase chain reaction (PCR) and Southern blot DNA analysis.

    Results: The body cavity-based lymphoma cells were positive for Kaposi sarcoma-associated herpesvirus by PCR and were negative for other herpesviruses, including Epstein-Barr virus, cytomegalovirus, and human herpesviruses 6 and 7. Southern blot analysis of lymphoma DNA showed high levels of Kaposi sarcoma-associated herpesvirus (>40 to 80 genomes/cell). Clonal rearrangement of the immunoglobulin JH and JK genes was present, confirming the presence of a clonal B-cell proliferation.

    Conclusions: Kaposi sarcoma-associated herpesvirus may be involved in the development of malignant lymphoma after Kaposi sarcoma in HIV-negative patients. This type of lymphoma, in contrast to body cavity-based lymphoma related to the acquired immunodeficiency syndrome, may have an indolent clinical course.

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    1. Ann Intern Med November 15, 1996 vol. 125 no. 10 822-825
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