malignant lymphoma, large cell type.
PERICARDIAL FLUID CELLBLOCK: Primary effusion lymphoma (HHV8+) consistent with a post transplantation lymphoproliferative disorder (see note). Note: Immunostains on the cell block show many large atypical lymphoid cells that are positive for CD30, MUM1 and HHV8. The large cells are negative for CD19, CD3, CD5, CD10, BCL6, BCL2 and CD21. Rare enlarged cells are CD20+ but overall large cells are negative for CD20. CD3 and CD5 stain many admixed small T cells. MYC stains less than 10% of all cells, mostly weakly. Most large cells (approximately 90%) are positive for Ki-67 (proliferation). In situ hybridization for EBER is negative.
In summary, the findings are those of a primary effusion lymphoma, which is a rare, HHV8-related large B-cell lymphoma. In this patient status post renal transplant, the lymphoma can be considered an unusual type of post transplantation lymphoproliferative disorder.
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Clinical history
58 yo M post renal transplant with pericardial effusion
Diagnosis
Suspicious for malignancy- Single cells with prominent nucleoli and coarse chromatin highly suspicious for malignant lymphoma, large cell type. PERICARDIAL FLUID CELLBLOCK: Primary effusion lymphoma (HHV8+) consistent with a post transplantation lymphoproliferative disorder (see note). Note: Immunostains on the cell block show many large atypical lymphoid cells that are positive for CD30, MUM1 and HHV8. The large cells are negative for CD19, CD3, CD5, CD10, BCL6, BCL2 and CD21. Rare enlarged cells are CD20+ but overall large cells are negative for CD20. CD3 and CD5 stain many admixed small T cells. MYC stains less than 10% of all cells, mostly weakly. Most large cells (approximately 90%) are positive for Ki-67 (proliferation). In situ hybridization for EBER is negative. In summary, the findings are those of a primary effusion lymphoma, which is a rare, HHV8-related large B-cell lymphoma. In this patient status post renal transplant, the lymphoma can be considered an unusual type of post transplantation lymphoproliferative disorder.
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