Bruce-Brand Cassandra, Rigby Jonathan
National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa.
Stellenbosch University, Cape Town, South Africa.
Int J Surg Pathol. 2020 Dec;28(8):868-871. doi: 10.1177/1066896920917212. Epub 2020 May 27.
Primary effusion lymphoma is a rare, clinically aggressive large B-cell neoplasm universally associated with human herpesvirus 8 that occurs in the setting of immune compromise. It is classically described as a lymphomatous effusion occurring within body cavities. Recently, however, solid tumor masses, and rarely an intravascular form, have been described. We report a case of a cutaneous intravascular primary effusion lymphoma occurring within ectatic vascular spaces of a Kaposi sarcoma skin lesion in a human immunodeficiency virus-positive adult. Human herpesvirus 8 immunohistochemistry was positive in the nuclei of the Kaposi sarcoma spindled cells as well as within large intravascular plasmacytoid cells. This unusual case highlights the importance of careful assessment of the nature of human herpesvirus 8-positive staining cells in an otherwise typical Kaposi sarcoma. A careful search for dual pathology in immune-compromised patients as well as the importance of histologic assessment of skin lesions in human immunodeficiency virus-positive patients is also highlighted.
原发性渗出性淋巴瘤是一种罕见的、临床上具有侵袭性的大B细胞肿瘤，普遍与人类疱疹病毒8型相关，发生于免疫功能低下的情况下。它传统上被描述为发生在体腔内的淋巴瘤性渗出液。然而，最近也有实体瘤肿块的报道，血管内形式则更为罕见。我们报告了一例皮肤血管内原发性渗出性淋巴瘤，发生在一名人类免疫缺陷病毒阳性成年人的卡波西肉瘤皮肤病变的扩张血管腔内。人类疱疹病毒8型免疫组化在卡波西肉瘤梭形细胞的细胞核以及大的血管内浆细胞样细胞内呈阳性。这个不寻常的病例凸显了在看似典型的卡波西肉瘤中仔细评估人类疱疹病毒8型阳性染色细胞性质的重要性。同时也强调了对免疫功能低下患者进行双重病理仔细检查的重要性，以及对人类免疫缺陷病毒阳性患者皮肤病变进行组织学评估的重要性。
