Licci Stefano, D'Antonio Antonio, Boscaino Amedeo, Morelli Luca, Piscioli Francesco, Abbate Isabella, Donnorso Raffaele Perrone, Del Nonno Franca
Department of Pathology, National Institute for Infectious Diseases (INMI) L. Spallanzani, Rome, Italy.
Acta Haematol. 2007;118(1):47-52. doi: 10.1159/000102587. Epub 2007 May 14.
The association between lymphomas and Kaposi's sarcoma has been described since 1920. The simultaneous presence of the 2 pathologic entities within the same lymph node is a rare and interesting occurrence. In the few cases described, the presence of human herpesvirus 8 (HHV8) and Epstein-Barr virus (EBV) in the different neoplastic areas was investigated only by immunohistochemistry and in situ hybridization studies.
Two cases of concurrent non-Hodgkin lymphoma and Kaposi's sarcoma in the same lymph node are described: a diffuse large B cell lymphoma in an AIDS patient and a T cell-rich large B cell lymphoma in a HIV-negative patient, complete with the clinical, immunohistological and molecular features, the latter ones defined after isolation of the different neoplastic areas by laser capture microdissection.
Polymerase chain reaction assays revealed HHV8 DNA sequences only in the microdissected Kaposi's sarcoma areas and EBV DNA sequences only in the lymphomatous areas in both cases, confirming the HHV8 infection only in the neoplastic sarcomatous cells and evidencing the EBV infection only in the lymphomatous cells.
This study represents a further confirmation of the supposed different etiopathogenic mechanisms of the 2 neoplasias, suggesting a coincidental occurrence even when localized in the same lymph node, independently from HIV infection.
自1920年以来，淋巴瘤与卡波西肉瘤之间的关联就已被描述。同一淋巴结内同时存在这两种病理实体是一种罕见且有趣的现象。在已描述的少数病例中，仅通过免疫组织化学和原位杂交研究对不同肿瘤区域中人疱疹病毒8（HHV8）和爱泼斯坦 - 巴尔病毒（EBV）的存在情况进行了调查。
描述了两例同一淋巴结内同时存在非霍奇金淋巴瘤和卡波西肉瘤的病例：一例为艾滋病患者的弥漫性大B细胞淋巴瘤，另一例为HIV阴性患者的富于T细胞的大B细胞淋巴瘤，并完整阐述了其临床、免疫组织学和分子特征，后者是在通过激光捕获显微切割分离不同肿瘤区域后确定的。
聚合酶链反应检测显示，两例病例中，仅在显微切割的卡波西肉瘤区域检测到HHV8 DNA序列，仅在淋巴瘤区域检测到EBV DNA序列，证实HHV8仅感染肿瘤性肉瘤细胞，EBV仅感染淋巴瘤细胞。
本研究进一步证实了这两种肿瘤假定的不同发病机制，表明即使它们位于同一淋巴结，也是偶然发生的，与HIV感染无关。
