Simultaneous occurrence of Epstein-Barr virus associated Hodgkin's disease and HHV-8 related multicentric Castleman's disease: a fortuitous event?

Abstract

Previous serological or molecular studies by means of the polymerase chain reaction have failed to show an association between classic Hodgkin's disease (HD) and human herpesvirus 8 (HHV-8). Using immunohistochemistry, this study re-examines (with anti-LNA1 antibody) the possible association of HHV-8 with HD, particularly in human immunodeficiency virus (HIV) infected patients. HHV-8 was not detected in the Reed Sternberg cells of the cases examined (33 HIV negative and 17 HIV positive), thus confirming the lack of involvement of HHV-8 in HD. Interestingly, a case of HHV-8 positive multicentric Castleman's disease was associated with Epstein-Barr virus positive HD in the same lymph node, which was probably a fortuitous occurrence.

Figure 1 Lymph node from a human immunodeficiency virus positive patient presenting with multicentric Castleman's disease associated with Epstein-Barr virus (EBV) positive Hodgkin's disease (HD). Double staining showing the expression of latent nuclear antigen 1 (LNA1) and latent membrane protein 1 (LMP1). The periphery of the follicle contains a population of plasma cell-like lymphocytes (arrow) infected by human herpesvirus 8 (HHV-8) (LNA1+, LMP1-), some of which are close to the HD area (with many binucleated and multinucleated atypical cells and diagnostic Reed Sternberg cells) (arrowhead) infected by EBV (LMP1+,LNA1-). Anti-LNA1 antibody (clone LN53), peroxidase (brown); anti-LMP1 antibody (clone CS 1–4), alkaline phosphatase (blue); original magnification, x1000.