Primary effusion lymphoma of the pleural space: Report of a rare complication of cardiac transplant with review of the literature

Transpl Infect Dis. 2019 Feb;21(1):e13005. doi: 10.1111/tid.13005. Epub 2018 Oct 30.

Abstract

Primary effusion lymphoma (PEL) is a rare mature B-cell non-Hodgkin's lymphoma arising in body cavities and presenting with effusions. It has been described predominantly in patients with impaired immunity from the acquired immunodeficiency syndrome and is associated with the Human Herpesvirus-8 (HHV-8). Seldom has PEL been diagnosed in persons negative for the human immunodeficiency virus (HIV), and in such cases it has occurred primarily in the setting of posttransplant immunosuppression. We report an instructive case of a Caribbean-American HIV-negative orthotopic heart transplant recipient with a history of HHV-8-associated Kaposi's sarcoma who developed HHV-8 viremia and PEL of the pleural space early in the posttransplant course. This case highlights the importance of considering PEL in the differential diagnosis of a new pleural effusion in a transplant recipient at risk for HHV-8-associated disease.

Keywords: heart transplant; human herpesvirus-8; pleural effusion; primary effusion lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Diagnosis, Differential
  • Heart Transplantation / adverse effects*
  • Herpesvirus 8, Human / isolation & purification*
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Immunosuppression Therapy / methods
  • Lymphoma, Primary Effusion / diagnosis*
  • Lymphoma, Primary Effusion / immunology
  • Lymphoma, Primary Effusion / pathology
  • Lymphoma, Primary Effusion / virology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / virology
  • Pleural Cavity / pathology
  • Pleural Cavity / virology
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / immunology
  • Postoperative Complications / virology
  • Sarcoma, Kaposi / immunology
  • Sarcoma, Kaposi / pathology
  • Sarcoma, Kaposi / virology
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / virology
  • Viremia / diagnosis*
  • Viremia / immunology
  • Viremia / virology