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This is an aggressive type of lymphoma characterized by a diffuse, monoclonal proliferation of plasmablasts that destroys the architectural structure of the organ in which they are located. The neoplastic cells have a terminally differentiated B-cell phenotype, with MUM1 expression and loss of CD79 and/or CD20 expression, and are infected by HHV8.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In this paper we describe the case of a 50-year-old man diagnosed with HIV infection in 2015 in the context of a herpes zoster virus infection. The patient had been receiving a highly active antiretroviral therapy (HAART) from the time of diagnosis of this condition, had an undetectable viral load since August 2015, and a CD4+ lymphocyte count of 200–400/μl. As HIV-associated complications, he developed a Kaposi sarcoma on the sole of his right foot in September 2015, which was treated with doxorubicin and is currently in resolution, as well as a HHV8-associated MCD in February 2018, which was treated with four cycles of rituximab and whose remission was subsequently confirmed with a positron emission tomography (PET)/computed tomography (CT) scan in May 2018.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In March 2019, he consulted for an episode of colicky epigastric pain radiating toward his right hypochondrium and associated with two to three daily diarrheic bowel movements. An ultrasound and abdominal CT scan were consequently performed, revealing ileocecal invagination secondary to the presence of a neoplastic, intestinal mass. A subsequent fibrocolonoscopy showed a neoplastic mass in his transverse colon, which was biopsied. The histological study of these biopsy samples showed a CD3+ and CD20− atypical lymphoid proliferation, because of which additional biopsies were requested to perform further immunophenotypic and molecular testing. However, given the risk of ischemia due to the intestinal invagination, a right hemicolectomy was finally carried out. The surgical specimen obtained during this procedure contained an exophytic neoplastic lesion in the cecum, with a maximum diameter of 6 cm. The histological studies showed a diffuse proliferation of B cells with plasmablastic differentiation ulcerating the intestinal mucosa and infiltrating the intestinal muscle. The neoplastic cells were positive for PAX5, CD79 (focally), MUM1, and lambda light chains, and negative for CD20, CD10, BCL6, kappa light chains, CD30, ALK, and CMYC. An aberrant expression of CD3 was also detected, with a negative expression of the remaining T markers (CD2, CD5, CD7, CD4, and CD8). The cell proliferation index (Ki67) was over 90%. Intense and diffuse positivity was also observed for the LANA1 antigen of HHV8, whereas <span class="elsevierStyleItalic">in situ</span> hybridization for the Epstein-Barr virus (EBV) was negative. Thus, based on the above findings, a diagnosis of HHV8+ DLBCL was reached.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Because a subsequent staging PET-CT scan detected hypermetabolic, infracentimetric adenopathies in the right axilla and a bone marrow biopsy showed no signs of infiltration by the lymphoma, the disease was finally classified as a stage IVA, IPI1 lymphoma and treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy, which resulted in its complete remission. The patient is still alive and disease-free 12 months after the diagnosis.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Human herpesvirus 8-positive diffuse large B-cell lymphoma is a very rare lymphoma that has recently been included in the WHO classification of hematologic malignancies. It is a lymphoma with a complex diagnosis that should raise a differential diagnosis with other lymphomas with plasmablastic differentiation, such as the solid variant of primary effusion lymphoma, plasmablastic lymphoma, or DLBCL with plasmablastic differentiation, among others. Its etiopathogenesis is closely related to HHV8 and, therefore, it is not uncommon for it to develop in patients with other diseases associated with this virus.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The case presented herein illustrates the onset of three different HHV8-related diseases, including Kaposi’s sarcoma, MCD, and HHV8+ DLBCL presenting consecutively in an HIV+ patient.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hernández-Gallego A, Navarro J-T, Tapia G. Linfoma difuso de célula grande B HHV8+ en un paciente con infección por el VIH. Med Clin (Barc). 2021;157:306–307.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO classification of tumours of haematopoietic and lymphoid tissues" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.H. Swerdlow" 1 => "E. Campo" 2 => "N.L. Harris" 3 => "J. ES" 4 => "S.A. Pileri" 5 => "H. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "4th ed." "fecha" => "2017" "editorial" => "IARC" "editorialLocalizacion" => "Lyon" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "KSHV/HHV8-positive large B-cell lymphomas and associated diseases: a heterogeneous group of lymphoproliferative processes with significant clinicopathological overlap" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Vega" 1 => "R.N. Miranda" 2 => "L.J. Medeiros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41379-019-0365-y" "Revista" => array:7 [ "tituloSerie" => "Mod Pathol" "fecha" => "2020" "volumen" => "33" "paginaInicial" => "18" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31527708" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0167527316319787" "estado" => "S300" "issn" => "01675273" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High incidence of Kaposi sarcoma-associated herpesvirus-related non-Hodgkin lymphoma in patients with HIV infection and multicentric Castleman disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Oksenhendler" 1 => "E. Boulanger" 2 => "L. Galicier" 3 => "M.Q. Du" 4 => "N. Dupin" 5 => "T.C. Diss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood.v99.7.2331" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2002" "volumen" => "99" "paginaInicial" => "2331" "paginaFinal" => "2336" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11895764" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015700000006/v2_202201010922/S2387020621004332/v2_202201010922/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015700000006/v2_202201010922/S2387020621004332/v2_202201010922/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621004332?idApp=UINPBA00004N" ]
