DISCUSSION
Primary effusion lymphoma is a rare lymphoma that usually occurs in
immunosuppressed middle-aged males. Recent reports also described PEL in
immunocompetent HIV-negative patients, mainly associated with HHV-8
infection in endemic areas. The most widely used protocol is the
intensive chemotherapy combination known as the CHOP protocol, designed
for aggressive lymphoma. It is accompanied by serious adverse side
effects, a low remission rate, and short duration of remissions in those
who do respond.
In most reports, the estimated life expectancy of immunocompromised PEL
patients is of a few months, commonly reported as six to nine months.
The reason probably relates to the progressive nature of the disease,
patients comorbidities, compromised immune system status, procedural
complications, failure of treatment and adverse effect of chemotherapy.
Our case highlights an extremely rare scenario of PEL that occurred in
an immunocompetent HIV-negative elderly female in a non HHV8-endemic
area. PEL, as seen in our case, involved both the pleural and the
pericardial spaces. Despite the patient’s advanced age, her overall
physical and cognitive function were intact. The patient chose not to be
treated with chemotherapy and her sole treatment was prednisone. Over a
course of 30 months, there were no adverse events. The patient is still
alive and in complete remission and maintains an excellent quality of
life.