Unusual immunophenotypic variant of large B-cell lymphoma associated with HHV-8 and EBV in an HIV positive patient

Human herpesvirus type 8, also known as Kaposi's sarcoma-associated herpesvirus (HHV-8/KSHV) has been associated with several lymphoproliferative disorders including Kaposi's sarcoma, primary effusion lymphoma (PEL), cases of multicentric Castleman's disease (MCD) including plasmablastic lymphoma associated with MCD, and germinotropic lymphoproliferative disorder. These lymphoproliferative disorders, with the exception of the latter, usually arise in HIV-positive or profoundly immunosuppressed patients. Herein, we describe an unusual large B-cell lymphoma in a 43 year-old male infected with HIV who presented with multiple lymphadenopathies. The tumor cells were positive for EBV, HHV-8/KSHV, CD20 (small subset), PAX5, and IgM and negative for CD138, and IgG. This lymphoma is difficult to classify following the 2008 WHO criteria and expands the current spectrum of viral-associated lymphomas.