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Clinical history
61 yo M with HIV and new axillary and mediastinal LAD
Diagnosis
Positive for malignancy- HHV8-positive large cell lymphoma, consistent with primary effusion lymphoma NOTE: The pleural fluid specimen consists of abundant large, atypical lymphoid cells with oval to irregular, convoluted nuclei, dispersed chromatin, and multiple small, prominent nucleoli with a moderate amount of brightly eosinophilic cytoplasm. Immunohistochemistry reveals that the large lymphoid cells stain positively for HHV8 and CD30. CD3 shows weak staining in rare large lymphoid cells and highlights a small population of admixed small, reactive T cells. CD20 and Pax-5 are negative. In-situ hybridization for EBV (EBER) is negative. Overall, the morphologic and immunohistochemical features are consistent with HHV8-related primary effusion lymphoma. An unusual feature is the absence of EBV as most primary effusion lymphomas are co-infected by HHV8 and EBV.
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