s. ziadi, md; m. bongiovanni, md, miac; cytopathologie
TRANSCRIPT
S. Ziadi, MD; M. Bongiovanni, MD, MIAC; Cytopathologie, CHUV, Lausanne
Male, 88 yo
Presented with abundant pericardial effusion Unremarkable clinical history
Absence of any expanding mass on imaging
Clinical information
Pericardial effusion fluid for cytological examination
Pap, 400x
Cytological features
Pap, 600x
Pap, 600x
Giemsa, 600x
Giemsa, 600x
Cytobloc, 600x
Cytobloc, 600x
Immunocytochemistry
CD20, cytobloc, 400x
Immunocytochemistry
CD3, CD5: BCL-2, MUM-1, CD138, CD23, CD5, Tdt: MYC:
Calretinin, Ber-Ep4, CK7 :
Negatives
Rares T cells positives
Nuclear positivity, 35% of cells
Negatives
Immunocytochemistry
-EBV ISH EBER
-EBV-LMP1
-HHV-8
Negatives
FISH sur cytobloc
-BCL2 FISH DNA Probe, Split Signal (18q21)
-BCL6 FISH DNA Probe, Split Signal (3q27)
-MYC Dual Color Break Apart Rearrangement Probe (8q24)
B. Bisig, MD, Molecular Pathology Lab, Institute of Pathology, CHUV, Lausanne
No rearrangements
Cytological diagnosis
HHV-8 unrelated PEL – LL
-HHV-8 unrelated
primary effusion lymphoma-like lymphoma-
PEL is a rare type of non-Hodgkin lymphoma arising from a B-cell
lineage
It is confined to lymphomatous effusion in a body cavity
There are not detectable tumor masses
PEL is usually found in HIV-positive immunocompromised patients
PEL is usually positive for HHV-8 infection.
Primary effusion lymphoma- PEL
Discussion
PEL has poor prognosis and yet no standard treatment exists
The median survival is 4 months
PEL may also occur in HIV-negative individuals who are not
immunosuppressed and in the absence of HHV-8 infection.
Primary effusion lymphoma- PEL
Discussion
HHV-8 unrelated PEL-LL - primary effusion lymphoma-like lymphoma-
PEL-LL usually occurs in elderly individuals
PEL-LL follows a more indolent prognosis then PEL
HHV-8 unrelated PEL-LL - primary effusion lymphoma-like
lymphoma-
Discussion
Kim HJ, et al. Human herpes virus 8-unrelated primary effusion lymphoma-like lymphoma presenting with cardiac tamponade: A case report. Medicine (Baltimore). 2017 Oct;96(43):e8010.