Primary Effusion Lymphoma: A Timely Review on the Association with HIV, HHV8, and EBV.
Chih-Yi LiuBo-Jung ChenShih-Sung ChuangPublished in: Diagnostics (Basel, Switzerland) (2022)
Primary effusion lymphoma (PEL) is defined by the WHO classification as a large B-cell neoplasm without detectable tumor masses. It is universally associated with HHV8, with most cases occurring in the setting of immunodeficiency such as HIV infection, and a poor prognosis. Morphologically, the neoplastic cells range from immunoblastic, plasmablastic, to anaplastic; and phenotypically, most cases express plasma cell but not B-cell markers, i.e., plasmablastic. During the past decade, primary HHV8-negative effusion lymphoma has been reported. Such cases were considered in the WHO classification scheme as effusion-based lymphoma. We performed a systemic review of 167 HHV8-negative effusion lymphomas from the literature and found that only 42% were associated with a fluid overload state, and with low rates of HIV (6%) or EBV (21%) infection. Furthermore, most patients are old (or immunosenescent) with underlying medical conditions/comorbidities, most neoplasms are of B-cell phenotype, and the outcome is more favorable than that of HHV8-positive PEL. These distinctive findings supported our prior proposal of designating these HHV8-negative cases as type II PEL, in contrast to the classic or type I PEL as defined by the WHO. Furthermore, we propose an algorithmic approach for the diagnosis of PEL and its mimickers.
Keyphrases
- diffuse large b cell lymphoma
- poor prognosis
- antiretroviral therapy
- epstein barr virus
- hiv positive
- hiv infected
- human immunodeficiency virus
- deep learning
- long non coding rna
- machine learning
- hepatitis c virus
- hiv testing
- end stage renal disease
- healthcare
- hiv aids
- induced apoptosis
- ejection fraction
- newly diagnosed
- magnetic resonance
- single cell
- magnetic resonance imaging
- men who have sex with men
- cell cycle arrest
- prognostic factors
- patient reported outcomes
- signaling pathway
- cell death
- ultrasound guided
- cell proliferation
- stem cells
- south africa
- bone marrow
- drug induced