PMC9791082_01
Histologic features of tissue biopsies. The first biopsy (left column) shows morphologic features that are expected on the spectrum of HIV lymphadenopathy, with generally uniform appearing germinal centers and paracortical hyperplasia (A; objective magnification x4), The cellular architecture of the germinal centers is preserved (B; objective magnification x10) and only rare, small lymphocytes are HHV8-LANA-positive (C; arrows; objective magnification x10). In contrast the second biopsy (right column) demonstrates small germinal centers (D; objective magnification x4), showing stromal hyalinizaiton and decreased cellularity (E; objective magnification x10). Numerous HHV8-LANA-positive plasmablasts rim the atretic follicles (F; arrows; objective magnification x10), diagnostic of MCD.
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An excisional lymph node biopsy ( Figure 1 ) showed non-specific histologic features compatible with HIV-lymphadenopathy, with generally uniform geminal centers and prominent paracortical hyperplasia. A repeat excisional biopsy ( Figure 1 ) showed features strongly consistent with KSHV-MCD including variably involuted germinal centers rimmed by LANA-1 positive plasmablasts and did not demonstrate tuberculosis, fungal infection, or other lymphoma.