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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
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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.


Grahic Jump Location
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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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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