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Diverse clinicopathologic features in human herpesvirus 8-associated lymphomas lead to diagnostic problems.

由人类疱疹病毒8相关淋巴瘤患者病理特征不同而导致的诊断问题。

Courville EL,Sohani AR,Hasserjian RP,Zukerberg LR,Harris NL,Ferry JA

Abstract

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.
We identified 15 patients with HHV8-associated lymphomas and evaluated their clinical and pathologic features.
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.
HHV8-associated lymphomas can be clinically and pathologically heterogeneous, with features that may lead to misdiagnosis as other types of lymphoma.

摘要

人类疱疹病毒8(HHV8)相关淋巴瘤不常见,主要影响感染了人类免疫缺陷病毒(HIV)的患者,通常预后不良。我们试图描述自1990年代中期以来在我们机构所发现HHV8+淋巴瘤。
我们确定了15例HHV8相关淋巴瘤,并评估其临床和病理特点。
诊断包括初期积水型淋巴瘤(PEL)(N=2),腔外PEL(N=8),血管内大B细胞淋巴瘤(N=1),HHV8+浆母细胞性微淋巴瘤(N=3),和多中心性淋巴组织增生症(GLD)的(N=1)。GLD进展到高级别HHV8+Epstein-Barr病毒阳性淋巴瘤的病例,此前还没有报道过。有4例患者HIV阴性(其中3例来自HHV8流行区)。在腔外PEL的病例中存在一些可能导致误诊的病理特征包括经典型霍奇金淋巴瘤样特征,淋巴结窦受累和T细胞抗原的表达。
HHV8相关淋巴瘤可能具有临床表现和病理形态的异质性,其某些特征可能导致误诊为其它类型的淋巴瘤。

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