Beukes C A & Thiart J
(2012) Histopathology 61, 942–944
The incidence of human herpes virus‐8 expression in lymph node biopsies from human immunodeficiency virus‐positive patients
Aims: Human immunodeficiency virus (HIV)‐related lymphadenopathy is characterized by a wide spectrum of histological changes. Three patterns have been described which correspond to clinical stages of HIV/acquired immune deficiency syndrome (AIDS). Castleman disease is a heterogeneous group of disorders. A recently described variant, multicentric Castleman disease (MCD), of which some cases are associated with human herpes virus‐8 (HHV‐8), has been reported in both HIV‐seropositive and ‐negative patients. Considerable morphological overlap occurs between one of the patterns of HIV lymphadenopathy and this variant.
Methods and results: This retrospective histopathological study on 95 cases of HIV‐reactive lymphadenopathy assessed the incidence of the different patterns and HHV‐8 on immunohistochemistry (IHC). Of the 95 cases, 78 (82.1%) were HHV‐8‐negative, of which 46 (59.0%) were classified as pattern A, 20 (25.6%) as pattern B and 12 (15.4%) as pattern C. Nine (31.0%) of 29 cases with pattern B and 8 (40.0%) of 20 cases with pattern C were HHV‐8 positive. In total 15 cases of MCD were diagnosed in this series.
Conclusion: This study draws attention to the overlap between HIV lymphadenopathy and MCD. We recommend that cases of HHV‐8‐associated MCD should be investigated for HIV infection.