2. Department of Histopathology, Shefa Al-Orman Oncology Hospital, Luxor, Egypt.
3. Department of Medical Oncology, Shefa Al-Orman Oncology Hospital, Luxor, Egypt.
4. Department of Medical Oncology, National Cancer Institute, Cairo University, Egypt.
5. Department of Pathology, Faculty of medicine, Alexandria University, Egypt.
6. Department of Histopathology, Imperial College London, United Kingdom.
Although rare, but there are case reports of lymphoproliferative disorders that are associated with human immunodeficiency virus (HIV) negative Kaposi’ sarcoma (KS), including Hodgkin lymphoma (HL). The majority of these cases show involvement by lymphoma and KS in different organs. Only 6 cases of concurrent HL and KS within the same lymph node have been documented in previous literature. These cases of HL are predominantly of classic type (cHL), with only one that showed simultaneous Nodular lymphocyte predominance Hodgkin lymphoma (NLPHL) with primary intra-nodal KS (no skin lesions presented).
We report the first case of a 26-year-old HIV negative gentleman with cutaneous KS metastatic to a lymph node primarily involved by NLPHL. Interestingly, in our case, Epstein Barr Virus (EBV) was found to be expressed in cells of both tumours.
Neither EBV nor Human Herpes Virus -8 (HHV-8) were found in association with both KS and HL by itself. EBV has an established role in the pathogenesis of classical HL. Loss of immune surveillance in immunodeficiency states, such as HIV infection, may predispose individuals to the development of EBV-associated cHL. It is possible that EBV infection of a B cell replaces one of the genetic alterations necessary for the development of classical HL.
Keywords: Kaposi sarcoma, NLPHL, HIV, HHV8, EBV