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Body Cavity-Based Malignant Lymphoma Containing Kaposi Sarcoma-Associated Herpesvirus in an HIV-Negative Man with Previous Kaposi Sarcoma

James A. Strauchen, MD; A. Daniel Hauser, MD; David Burstein, MD; Ricardo Jimenez, MD; Patrick S. Moore, MD; and Yuan Chang, MD
[+] Article and Author Information

From Mount Sinai School of Medicine and Columbia University College of Physicians and Surgeons, New York, New York. Requests for Reprints: James A. Strauchen, MD, Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029. Current Author Addresses: Drs. Strauchen, Burstein, and Jimenez: Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1996;125(10):822-825. doi:10.7326/0003-4819-125-10-199611150-00006
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Background: The role of Kaposi sarcoma-associated herpesvirus in the development of malignant lymphomas in patients negative for the human immunodeficiency virus (HIV) has not been established.

Objective: To examine the possible role of Kaposi sarcoma-associated herpesvirus in a case of body cavity-based malignant lymphoma that occurred in an HIV-negative patient who had previously had Kaposi sarcoma.

Design: Case study.

Setting: Academic medical center.

Patient: A 94-year-old man with lymphomatous ascites.

Measurements: Polymerase chain reaction (PCR) and Southern blot DNA analysis.

Results: The body cavity-based lymphoma cells were positive for Kaposi sarcoma-associated herpesvirus by PCR and were negative for other herpesviruses, including Epstein-Barr virus, cytomegalovirus, and human herpesviruses 6 and 7. Southern blot analysis of lymphoma DNA showed high levels of Kaposi sarcoma-associated herpesvirus (>40 to 80 genomes/cell). Clonal rearrangement of the immunoglobulin JH and JK genes was present, confirming the presence of a clonal B-cell proliferation.

Conclusions: Kaposi sarcoma-associated herpesvirus may be involved in the development of malignant lymphoma after Kaposi sarcoma in HIV-negative patients. This type of lymphoma, in contrast to body cavity-based lymphoma related to the acquired immunodeficiency syndrome, may have an indolent clinical course.

Figures

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Figure 1. Large lymphoma cells with pleomorphic nuclei and prominent nucleoli (original magnification, × 400).
Cytospin preparation of ascitic fluid cells treated with Papanicolaou stain.
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Figure 2. Genomic DNA samples were digested with BamHI and subjected to Southern blot hybridization with the KS631Bam probe. Lane 1 shows ascitic cells from the patient. The BC-1 cell line was used as a positive control (lane 2); P3HR1, a B-cell line positive for Epstein-Barr virus and negative for Kaposi sarcoma-associated herpesvirus, was used as a negative control (lane 3). In the ascitic cells and in the BC-1 cell line, a strong band migrating at 631 base pairs (bp) is shown.
Southern blot of Kaposi sarcoma-associated herpesvirus in malignant ascitic cells.
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