Serous fluid cytology of multicentric Castleman's disease and other lymphoproliferative disorders associated with Kaposi sarcoma-associated herpes virus: a review with case reports

• Published in: Cytopathology (Oxford) 2012-04, Vol.23 (2), p.76-85
• Main Authors: Lobo, C., Amin, S., Ramsay, A., Diss, T., Kocjan, G.
• Format: Article
• Language: English
• Subjects: 2-Methylisoborneol; Benign; Body Fluids - cytology; Body Fluids - virology; Case reports; Castleman Disease - complications; Castleman Disease - virology; Castleman's disease; CD2 antigen; CD20 antigen; CD3 antigen; CD30 antigen; CD4 antigen; CD45 antigen; cytology; Effusion; Epstein-Barr virus; Heavy chains; Herpes simplex; Herpesvirus; Herpesvirus 8, Human - physiology; Humans; Immunocytochemistry; Immunoglobulin M; Immunoglobulins; Immunohistochemistry; Immunoproliferative diseases; immunosuppression; Kaposi sarcoma-associated herpes virus; Kaposi's sarcoma-associated herpesvirus; KSHV; Lymphocytes B; Lymphoma, Primary Effusion - complications; Lymphoma, Primary Effusion - virology; lymphoproliferations; Lymphoproliferative Disorders - complications; Lymphoproliferative Disorders - virology; Male; Middle Aged; multicentric Castleman`s disease; p53 protein; plasmablastic lymphoma; plasmacytoid cells; Pleural Effusion - complications; Pleural Effusion - virology; Polymerase chain reaction; primary effusion lymphoma; serous fluids
• ISSN: 0956-5507; 1365-2303
• DOI: 10.1111/j.1365-2303.2011.00868.x

C. Lobo, S. Amin, A. Ramsay, T. Diss and G. KocjanSerous fluid cytology of multicentric Castleman’s disease and other lymphoproliferative disorders associated with Kaposi sarcoma‐associated herpes virus: a review with case reports Objective:  The aim of this study is to describe and review the cytological features of Kaposi sarcoma‐associated herpes virus (KSHV) related entities, such as multicentric Castleman’s disease (MCD), plasmablastic‐lymphoma (PBL) and primary effusion lymphoma (PEL), which all may present as body cavity effusions. Serous fluid cytology of MCD and PBL has not, to our knowledge, thus far been described. Although different in nature, MCD, PBL and PEL are characterized by similar morphological features. Materials and methods:  Body cavity effusions from four different patients with previously known or unknown KSHV‐related lymphoproliferations have been examined by routine cytology, immunocytochemistry (IC) and polymerase chain reaction (PCR). Results:  MCD, PBL and PEL are all characterized by increased cellularity, comprising mainly lymphoid and plasmacytoid cells with variable proportions of immunoblasts. Immunocytochemistry and PCR results show the MCD to be CD138 and KSHV positive, CD30 negative, IgM, IgH and lambda restricted but IgH polyclonal. PBL was CD138 positive, kappa restricted, weakly positive with VS38 and over 80% positive with MIB 1. PEL was CD45, EMA, CD138, KSHV, p53 and CD3 positive, CD20, EBV, CD30, CD2, CD4, ALK1, epithelial and mesothelial markers negative, and PCR monoclonal B‐cell expanded (Ig‐kappa bands). Conclusion:  Cytological examination of effusions in KSHV‐related lymphoproliferative disorders may show similar morphological features but clonality studies and immunocytochemistry are very helpful in distinguishing between these rare benign and malignant lymphoproliferative diseases.