Expanding the spectrum of Epstein-Barr virus and human herpesvirus-8 co-infection associated large B-cell lymphomas with plasmablastic differentiation in HIV-positive patients: Report of two unusual cases and review of the literature

Abstract

Background: EBV and HHV8 are both DNA human oncoviruses responsible for different lymphoproliferative disorders. Over the last decade, several authors have reported on lymphoproliferative disorders associated with HHV8 and EBV co-infection. In this article we report two unusual cases of HHV8 and EBV positive large B cell lymphoma with plasmablastic differentiation in HIV-positive patients which do not fulfill the criteria for the WHO Classification of lymphoproliferative disorders. Case presentation: Both patients are HIV positive. The first case involves a 37 year old male patient, severely immunocompromised, presenting with B symptoms and advanced stage lymphadenopathy which revealed a HHV8-positive, EBV-positive diffuse large B cell lymphoma with plasmablastic morphology and an aggressive disease course. The second case involves a 61 year old female patient presenting with multicentric Castleman disease, with lymph node histology showing associated foci of HHV-8 positive and EBV positive plasmablastic clusters. This case presented an indolent course without evidence of systemic involvement. Conclusions: These two cases expand on the current lymphoproliferative entities associated with co-infection of HHV8 and EBV large B cell lymphoma with plasmablastic differentiation, and reveal the gaps in current WHO classification of these types of lymphomas.

Keywords

• Plasmablastic
• EBV
• HHV8
• Co-infection