{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:12:03Z","timestamp":1788775923257,"version":"build-2803163510"},"reference-count":77,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Human herpesvirus 8 (HHV-8), also known as Kaposi sarcoma-associated herpesvirus (KSHV), is a gamma-2 herpesvirus implicated in a distinctive group of lymphoproliferative disorders (LPDs) and lymphomas. In some of these entities, lesional cells are concurrently infected with Epstein\u2013Barr virus (EBV), a gamma-1 herpesvirus, raising important questions regarding viral cooperation in lymphomagenesis. This narrative review summarizes the clinicopathological spectrum and biological significance of HHV-8\/EBV co-positive lymphoproliferations. Methods: We provide a narrative synthesis of the biology of HHV-8 and EBV, including latent, abortive lytic, and productive lytic infection programmes and viral mechanisms involved in cell-cycle deregulation, apoptosis inhibition, immune evasion, and B-cell transformation. Major HHV-8-associated lymphoproliferative entities are reviewed within the current WHO-HAEM5 and International Consensus Classification frameworks, with particular attention to patterns of EBV co-infection and diagnostically atypical or overlapping lesions. Results: Primary effusion lymphoma, including its extracavitary presentation, is frequently EBV-positive, whereas HHV-8-positive germinotropic lymphoproliferative disorder is characteristically HHV-8\/EBV dual-positive. In contrast, HHV-8-positive lesional cells in multicentric Castleman disease and HHV-8-positive diffuse large B-cell lymphoma are typically EBV-negative. True dual positivity requires demonstration of HHV-8 latency-associated nuclear antigen and EBV-encoded RNA within the same morphologically defined lesional cell population. Rare atypical cases show overlapping clinicopathological features among established entities. Conclusions: HHV-8\/EBV co-positive lymphoproliferations comprise a biologically and diagnostically heterogeneous group. Although unusual overlapping cases suggest potential relationships among HHV-8-associated disorders, current evidence does not support a single continuous disease spectrum or a uniform mechanism of HHV-8\/EBV cooperation.<\/jats:p>","DOI":"10.3390\/diseases14090323","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:23:37Z","timestamp":1788773017000},"page":"323","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Spectrum of Human Herpesvirus 8\/Epstein\u2013Barr Virus-Co-Positive Lymphoproliferations and Lymphomas"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0035-467X","authenticated-orcid":false,"given":"Epameinondas","family":"Koumpis","sequence":"first","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nasiou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1744-9069","authenticated-orcid":false,"given":"Georgios","family":"Monastiriotis","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6649-0491","authenticated-orcid":false,"given":"Dimitrios","family":"Leonardos","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1727-5997","authenticated-orcid":false,"given":"Vasileios","family":"Georgoulis","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3432-4209","authenticated-orcid":false,"given":"Elisavet","family":"Apostolidou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3932-6652","authenticated-orcid":false,"given":"Alexandra","family":"Papoudou-Bai","sequence":"additional","affiliation":[{"name":"German Medical Institute, 1, Nikis Avenue, 4108 Limassol, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8916-3276","authenticated-orcid":false,"given":"Panagiotis","family":"Kanavaros","sequence":"additional","affiliation":[{"name":"Department of Anatomy-Histology-Embryology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4408-5646","authenticated-orcid":false,"given":"Eleftheria","family":"Hatzimichael","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1126\/science.7997879","article-title":"Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi\u2019s sarcoma","volume":"266","author":"Chang","year":"1994","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1182\/blood.2019000931","article-title":"Overview of Castleman disease","volume":"135","author":"Dispenzieri","year":"2020","journal-title":"Blood"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.path.2019.03.003","article-title":"Castleman Disease","volume":"12","author":"Wang","year":"2019","journal-title":"Surg. Pathol. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1182\/blood-2018-11-852442","article-title":"Kaposi sarcoma-associated herpesvirus\/human herpesvirus 8-associated lymphoproliferative disorders","volume":"133","author":"Oksenhendler","year":"2019","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3643","DOI":"10.1182\/blood.V93.11.3643.411k38_3643_3653","article-title":"Human herpesvirus 8 infection in patients with POEMS syndrome-associated multicentric Castleman\u2019s disease","volume":"93","author":"Mohamed","year":"1999","journal-title":"Blood"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/PAS.0000000000000823","article-title":"KSHV-associated and EBV-associated Germinotropic Lymphoproliferative Disorder: New Findings and Review of the Literature","volume":"41","author":"Bhavsar","year":"2017","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1182\/blood.V88.2.645.bloodjournal882645","article-title":"Primary effusion lymphoma: A distinct clinicopathologic entity associated with the Kaposi\u2019s sarcoma-associated herpes virus","volume":"88","author":"Nador","year":"1996","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1097\/01.pas.0000138177.10829.5c","article-title":"KSHV-positive solid lymphomas represent an extra-cavitary variant of primary effusion lymphoma","volume":"28","author":"Chadburn","year":"2004","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","article-title":"The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms","volume":"36","author":"Alaggio","year":"2022","journal-title":"Leukemia"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1111\/his.14551","article-title":"Epstein-Barr virus reactivation influences clonal evolution in human herpesvirus-8-related lymphoproliferative disorders","volume":"79","author":"Granai","year":"2021","journal-title":"Histopathology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.humpath.2015.06.020","article-title":"Rare variants in the spectrum of human herpesvirus 8\/Epstein-Barr virus-copositive lymphoproliferations","volume":"46","author":"Hatzimichael","year":"2015","journal-title":"Hum. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/1066896917745584","article-title":"EBV+ HHV-8+ Multicentric Castleman Disease With Plasmablastic Aggregates in an HIV+ Man: An Evolving Clinicopathologic Entity","volume":"26","author":"Shivane","year":"2018","journal-title":"Int. J. Surg. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1053\/j.seminoncol.2014.12.026","article-title":"Epstein-barr virus- and Kaposi sarcoma-associated herpesvirus-related malignancies in the setting of human immunodeficiency virus infection","volume":"42","author":"Pinzone","year":"2015","journal-title":"Semin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"753","DOI":"10.5858\/2000-124-0753-EPLNIO","article-title":"Early peripheral lymph node involvement of human herpesvirus 8-associated, body cavity-based lymphoma in a human immunodeficiency virus-negative patient","volume":"124","author":"Ariad","year":"2000","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1136\/jcp.2005.026542","article-title":"KSHV\/HHV-8 associated lymph node based lymphomas in HIV seronegative subjects. Report of two cases with anaplastic large cell morphology and plasmablastic immunophenotype","volume":"58","author":"Carbone","year":"2005","journal-title":"J. Clin. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s12250-019-00114-3","article-title":"Towards Better Understanding of KSHV Life Cycle: From Transcription and Posttranscriptional Regulations to Pathogenesis","volume":"34","author":"Yan","year":"2019","journal-title":"Virol. Sin."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/978-3-642-38965-8_13","article-title":"Molecular biology of human herpesvirus 8: Novel functions and virus-host interactions implicated in viral pathogenesis and replication","volume":"193","author":"Cousins","year":"2014","journal-title":"Recent. Results Cancer Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1086\/654798","article-title":"An interleukin-6-related systemic inflammatory syndrome in patients co-infected with Kaposi sarcoma-associated herpesvirus and HIV but without Multicentric Castleman disease","volume":"51","author":"Uldrick","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1634\/theoncologist.2016-0237","article-title":"Kaposi Sarcoma Inflammatory Cytokine Syndrome (KICS): A Rare but Potentially Treatable Condition","volume":"22","author":"Karass","year":"2017","journal-title":"Oncologist"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Mui, U.N., Haley, C.T., and Tyring, S.K. (2017). Viral Oncology: Molecular Biology and Pathogenesis. J. Clin. Med., 6.","DOI":"10.3390\/jcm6120111"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1093\/jpids\/pit051","article-title":"A Review of Human Herpesvirus 8, the Kaposi\u2019s Sarcoma-Associated Herpesvirus, in the Pediatric Population","volume":"3","author":"Dow","year":"2014","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.canlet.2009.07.004","article-title":"Kaposi sarcoma-associated herpesvirus (KSHV): Molecular biology and oncogenesis","volume":"289","author":"Wen","year":"2010","journal-title":"Cancer Lett."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"14862","DOI":"10.1073\/pnas.93.25.14862","article-title":"Nucleotide sequence of the Kaposi sarcoma-associated herpesvirus (HHV8)","volume":"93","author":"Russo","year":"1996","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/B978-0-12-385032-4.00003-3","article-title":"Molecular biology of Kaposi\u2019s sarcoma-associated herpesvirus and related oncogenesis","volume":"78","author":"Cai","year":"2010","journal-title":"Adv. Virus Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5582\/irdr.2014.01010","article-title":"Current status of treatment for primary effusion lymphoma","volume":"3","author":"Okada","year":"2014","journal-title":"Intractable Rare Dis. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"845","DOI":"10.4161\/cc.27758","article-title":"Viral cyclin promotes KSHV-induced cellular transformation and tumorigenesis by overriding contact inhibition","volume":"13","author":"Jones","year":"2014","journal-title":"Cell Cycle"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0140-6736(90)90001-L","article-title":"Kaposi\u2019s sarcoma among persons with AIDS: A sexually transmitted infection?","volume":"335","author":"Beral","year":"1990","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"8247","DOI":"10.1128\/MCB.21.24.8247-8254.2001","article-title":"FLICE-inhibitory proteins: Regulators of death receptor-mediated apoptosis","volume":"21","author":"Krueger","year":"2001","journal-title":"Mol. Cell Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/QCO.0b013e3283486d04","article-title":"Human herpesvirus 8-associated neoplasms: The roles of viral replication and antiviral treatment","volume":"24","author":"Gantt","year":"2011","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5722","DOI":"10.1128\/JVI.73.7.5722-5730.1999","article-title":"A complex translational program generates multiple novel proteins from the latently expressed kaposin (K12) locus of Kaposi\u2019s sarcoma-associated herpesvirus","volume":"73","author":"Sadler","year":"1999","journal-title":"J. Virol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1128\/JVI.72.2.1005-1012.1998","article-title":"Transcription mapping of the Kaposi\u2019s sarcoma-associated herpesvirus (human herpesvirus 8) genome in a body cavity-based lymphoma cell line (BC-1)","volume":"72","author":"Sarid","year":"1998","journal-title":"J. Virol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"5570","DOI":"10.1073\/pnas.0408192102","article-title":"Kaposi\u2019s sarcoma-associated herpesvirus expresses an array of viral microRNAs in latently infected cells","volume":"102","author":"Cai","year":"2005","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1261\/rna.2326106","article-title":"A combined computational and microarray-based approach identifies novel microRNAs encoded by human gamma-herpesviruses","volume":"12","author":"Grundhoff","year":"2006","journal-title":"Rna"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nmeth746","article-title":"Identification of microRNAs of the herpesvirus family","volume":"2","author":"Pfeffer","year":"2005","journal-title":"Nat. Methods"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1016\/j.tim.2017.02.002","article-title":"KSHV microRNAs: Tricks of the Devil","volume":"25","author":"Qin","year":"2017","journal-title":"Trends Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/978-3-030-35727-6_9","article-title":"Tumor Microenvironment Conditioning by Abortive Lytic Replication of Oncogenic gamma-Herpesviruses","volume":"1225","author":"Munz","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Thakker, S., and Verma, S.C. (2016). Co-infections and Pathogenesis of KSHV-Associated Malignancies. Front. Microbiol., 7.","DOI":"10.3389\/fmicb.2016.00151"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3652","DOI":"10.1016\/j.cell.2022.08.026","article-title":"Epstein-Barr virus: Biology and clinical disease","volume":"185","author":"Damania","year":"2022","journal-title":"Cell"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/S0140-6736(64)91524-7","article-title":"Virus particles in cultured lymphoblasts from burkitt\u2019s Lymphoma","volume":"1","author":"Epstein","year":"1964","journal-title":"Lancet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1002\/path.1711680311","article-title":"High incidence of EBV genome in CD30-positive non-Hodgkin\u2019s lymphomas","volume":"168","author":"Kanavaros","year":"1992","journal-title":"J. Pathol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/path.1711700206","article-title":"Presence of Epstein-Barr virus harbouring small and intermediate-sized cells in Hodgkin\u2019s disease. Is there a relationship with Reed-Sternberg cells?","volume":"170","author":"Jiwa","year":"1993","journal-title":"J. Pathol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1002\/(SICI)1096-9896(199603)178:3<297::AID-PATH469>3.0.CO;2-E","article-title":"Epstein-Barr virus in non-Hodgkin\u2019s lymphomas of the upper respiratory tract: Association with sinonasal localization and expression of NK and\/or T-cell antigens by tumour cells","volume":"178","author":"Kanavaros","year":"1996","journal-title":"J. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1182\/blood.V81.10.2688.2688","article-title":"Nasal T-cell lymphoma: A clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus","volume":"81","author":"Kanavaros","year":"1993","journal-title":"Blood"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Murata, T., Sugimoto, A., Inagaki, T., Yanagi, Y., Watanabe, T., Sato, Y., and Kimura, H. (2021). Molecular Basis of Epstein-Barr Virus Latency Establishment and Lytic Reactivation. Viruses, 13.","DOI":"10.3390\/v13122344"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1111\/cas.13954","article-title":"Epstein-Barr virus strain variation and cancer","volume":"110","author":"Kanda","year":"2019","journal-title":"Cancer Sci."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Yu, H., and Robertson, E.S. (2023). Epstein-Barr Virus History and Pathogenesis. Viruses, 15.","DOI":"10.3390\/v15030714"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00430-018-0570-1","article-title":"Molecular mechanisms of EBV-driven cell cycle progression and oncogenesis","volume":"208","author":"Yin","year":"2019","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/s12985-023-02187-9","article-title":"Epstein-Barr virus infection: The micro and macro worlds","volume":"20","author":"Huang","year":"2023","journal-title":"Virol. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1038\/313812a0","article-title":"Stable replication of plasmids derived from Epstein-Barr virus in various mammalian cells","volume":"313","author":"Yates","year":"1985","journal-title":"Nature"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e133","DOI":"10.1038\/emm.2014.105","article-title":"Epstein-Barr virus-positive T\/NK-cell lymphoproliferative disorders","volume":"47","author":"Cai","year":"2015","journal-title":"Exp. Mol. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"154","DOI":"10.5501\/wjv.v1.i6.154","article-title":"Roles of the PI3K\/Akt pathway in Epstein-Barr virus-induced cancers and therapeutic implications","volume":"1","author":"Chen","year":"2012","journal-title":"World J. Virol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"121261","DOI":"10.1016\/j.lfs.2022.121261","article-title":"Insights into intricacies of the Latent Membrane Protein-1 (LMP-1) in EBV-associated cancers","volume":"313","author":"Awasthi","year":"2023","journal-title":"Life Sci."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ho, J.W.Y., Li, L., Wong, K.Y., Srivastava, G., and Tao, Q. (2023). Comprehensive Profiling of EBV Gene Expression and Promoter Methylation Reveals Latency II Viral Infection and Sporadic Abortive Lytic Activation in Peripheral T-Cell Lymphomas. Viruses, 15.","DOI":"10.3390\/v15020423"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"100200","DOI":"10.1016\/j.bneo.2026.100200","article-title":"Epigenetic activation of EBV BGLF4 determines antiviral-based regimen response in EBV+CNS lymphoproliferative disease","volume":"3","author":"Weigel","year":"2026","journal-title":"Blood Neoplasia"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1182\/blood.2022015851","article-title":"The International Consensus Classification of Mature Lymphoid Neoplasms: A report from the Clinical Advisory Committee","volume":"140","author":"Campo","year":"2022","journal-title":"Blood"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1182\/blood.2020005470","article-title":"KSHV\/HHV8-mediated hematologic diseases","volume":"139","author":"Cesarman","year":"2022","journal-title":"Blood"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1038\/modpathol.2009.36","article-title":"HHV8-positive, EBV-positive Hodgkin lymphoma-like large B-cell lymphoma and HHV8-positive intravascular large B-cell lymphoma","volume":"22","author":"Ferry","year":"2009","journal-title":"Mod. Pathol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41379-019-0365-y","article-title":"KSHV\/HHV8-positive large B-cell lymphomas and associated diseases: A heterogeneous group of lymphoproliferative processes with significant clinicopathological overlap","volume":"33","author":"Vega","year":"2020","journal-title":"Mod. Pathol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/his.13428","article-title":"Lymphoproliferative disorders with concurrent HHV8 and EBV infection: Beyond primary effusion lymphoma and germinotropic lymphoproliferative disorder","volume":"72","author":"Wang","year":"2018","journal-title":"Histopathology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1038\/modpathol.2016.233","article-title":"HHV8-related lymphoid proliferations: A broad spectrum of lesions from reactive lymphoid hyperplasia to overt lymphoma","volume":"30","author":"Martinez","year":"2017","journal-title":"Mod. Pathol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1097\/PAS.0000000000000128","article-title":"HHV-8-positive and EBV-positive intravascular lymphoma: An unusual presentation of extracavitary primary effusion lymphoma","volume":"38","author":"Crane","year":"2014","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1097\/PAS.0b013e31804d43d8","article-title":"HHV-8+, EBV+ multicentric plasmablastic microlymphoma in an HIV+ Man: The spectrum of HHV-8+ lymphoproliferative disorders expands","volume":"31","author":"Seliem","year":"2007","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/MOH.0000000000000060","article-title":"How do viruses trick B cells into becoming lymphomas?","volume":"21","author":"Cesarman","year":"2014","journal-title":"Curr. Opin. Hematol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.chom.2017.06.009","article-title":"Persistent KSHV Infection Increases EBV-Associated Tumor Formation In Vivo via Enhanced EBV Lytic Gene Expression","volume":"22","author":"McHugh","year":"2017","journal-title":"Cell Host Microbe"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"109056","DOI":"10.1016\/j.celrep.2021.109056","article-title":"KSHV infection drives poorly cytotoxic CD56-negative natural killer cell differentiation in vivo upon KSHV\/EBV dual infection","volume":"35","author":"Caduff","year":"2021","journal-title":"Cell Rep."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"8225","DOI":"10.1128\/JVI.00411-07","article-title":"Kaposi\u2019s sarcoma-associated herpesvirus latency-associated nuclear antigen 1 mimics Epstein-Barr virus EBNA1 immune evasion through central repeat domain effects on protein processing","volume":"81","author":"Kwun","year":"2007","journal-title":"J. Virol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/S0002-9440(10)64940-1","article-title":"Differential viral protein expression in Kaposi\u2019s sarcoma-associated herpesvirus-infected diseases: Kaposi\u2019s sarcoma, primary effusion lymphoma, and multicentric Castleman\u2019s disease","volume":"156","author":"Parravicini","year":"2000","journal-title":"Am. J. Pathol."},{"key":"ref_68","first-page":"142","article-title":"HHV-8 and EBV Positive Lymphoproliferative Disease: A Challenging Case","volume":"38","year":"2022","journal-title":"Turk. Patoloji Derg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"703","DOI":"10.3390\/hemato2040047","article-title":"KSHV\/HHV8-Associated Lymphoproliferative Disorders: Lessons Learnt from People Living with HIV","volume":"2","author":"Bower","year":"2021","journal-title":"Hemato"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/ajh.24251","article-title":"Classic and extracavitary primary effusion lymphoma in 51 HIV-infected patients from a single institution","volume":"91","author":"Guillet","year":"2016","journal-title":"Am. J. Hematol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1182\/blood-2002-02-0487","article-title":"KSHV- and EBV-associated germinotropic lymphoproliferative disorder","volume":"100","author":"Du","year":"2002","journal-title":"Blood"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1007\/s00277-020-04024-3","article-title":"Germinotropic lymphoproliferative disorder: A systematic review","volume":"99","author":"Zanelli","year":"2020","journal-title":"Ann. Hematol."},{"key":"ref_73","first-page":"40","article-title":"Epstein-Barr virus-associated B-cell lymphoproliferative disorders and lymphomas: A review","volume":"52","author":"Salas","year":"2020","journal-title":"Pathology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e231640","DOI":"10.1136\/bcr-2019-231640","article-title":"Human herpes virus 8-positive germinotropic lymphoproliferative disorder: First case diagnosed in the UK, literature review and discussion of treatment options","volume":"13","author":"Ghoneima","year":"2020","journal-title":"BMJ Case Rep."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Nabel, C.S., Sameroff, S., Shilling, D., Alapat, D., Ruth, J.R., Kawano, M., Sato, Y., Stone, K., Spetalen, S., and Valdivieso, F. (2019). Virome capture sequencing does not identify active viral infection in unicentric and idiopathic multicentric Castleman disease. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0218660"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1177\/1066896920921238","article-title":"Intrasinusoidal HHV8-EBV-Positive Large B-Cell Lymphoma With Features of Germinotropic Lymphoproliferative Disorder","volume":"28","author":"Valkov","year":"2020","journal-title":"Int. J. Surg. Pathol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.pathol.2017.03.003","article-title":"PD-L1 and Notch1 expression in KSHV\/HHV-8 and EBV associated germinotropic lymphoproliferative disorder: Case report and review of the literature","volume":"49","author":"Ronaghy","year":"2017","journal-title":"Pathology"}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/9\/323\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T09:52:35Z","timestamp":1788774755000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/9\/323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,5]]},"references-count":77,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diseases14090323"],"URL":"https:\/\/doi.org\/10.3390\/diseases14090323","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,5]]}}}