A 49-year-old HIV-positive gentleman presents to his local medical center with cervical lymphadenopathy without a known associated pleural effusion. A needle core biopsy is performed. Within the perinodal soft tissue (top of Figure 1A), there is an atypical infiltrate of large pleomorphic cells (Figure 1). These cells do not express cytokeratin (Cam 5.2 or OSCAR), SOX10, CD3, CD20, CD30, CD45, or CD79a. These cells do express CD43, CD138, and MUM1 (Figure 2). Both in situ hybridization studies for Epstein-Barr virus (EBV) and an immunohistochemical stain for human herpes virus 8 (HHV-8) are positive (Figure 3).
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Justin Juskewitch, M.D., Ph.D.
Resident, Anatomic/Clinical Pathology
Mayo Clinic
Kaaren Reichard, M.D.
Consultant, Division of Hematopathology
Mayo Clinic
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine