Primary effusion lymphoma

ICD-O-3 Morphology

9678/3: Primary effusion lymphoma
Effective 2001 and later


for cases diagnosed 2001 and later

Primary Site(s)

See Module 7
Most common sites of involvement: body cavities (pleural, pericardial, and peritoneal). Extracavity lesions may occur in: GI tract, skin, lung, and CNS, and lymph nodes.

Abstractor Notes

PEL is universally associated with human herpes virus 8 (HH8).

PEL is unusual in that the majority of cases arise in body cavities (typically only one body cavity is involved). Because there are no ICD-O-3 codes for the pleural space, pericardium, or peritoneal cavity, code the primary site to:
1. Pleura (C384) when it occurs in the pleural cavity
2. Pericardium (C380) when it occurs in the pericardium
3. Peritoneum (C482) when it occurs in the peritoneal cavity.

PEL is generally resistant to cancer chemotherapy drugs that are active against other lymphomas, and carries a poor prognosis.

Diagnostic Confirmation

This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.


Not Applicable

Module Rule


Alternate Names

Body-cavity based lymphoma [OBS]
Extracavitary PEL


Primary effusion lymphoma (PEL) is a large B-cell neoplasm usually presenting as serous effusions without detectable tumor masses. It is universally associated with the human herpesvirus 8 (HHV8). It most often occurs in the setting of immunodeficiency. Some patients with PEL secondarily develop solid tumors in adjacent structures such as the pleura. Rare HHV8-positive lymphomas indistinguishable fro PEL present as solid tumor masses and have been termed extracavitary PEL.

Definitive Diagnostic Methods

Genetic testing
Histologic confirmation

Genetics Data

IG genes (so-called genotypic infidelity) rearrangement
Immunoglobulin genes clonally rearranged and hypermutated
TR genes are clonally rearranged


BCL6 absent
CD19 lacking
CD20 lacking
CD30 (often demonstrable)
CD38 (often demonstrable)
CD45 expression
CD79a lacking
CD138 (often demonstrable)
EMA (often demonstrable)
HLA-DR (often demonstrable)
LANA (ORF 73) (HHV8-associated latent protein)
Surface and cytoplasmic immunoglobulin absent
T-NK cell antigens expressed (in extracavitary PEL)
VS38c (often demonstrable)


Other therapy

Transformations to

There are no known transformations

Transformations from

There are no known transformations

Corresponding ICD-9 Codes

200.7 Large cell lymphoma

Corresponding ICD-10 Codes

C83.8 Other types of diffuse non-Hodgkin lymphoma

Corresponding ICD-10-CM Codes (U.S. only)

C83.8 Other non-follicular lymphoma (effective October 01, 2015)

Signs and Symptoms

Drenching night sweats
Fever (for no known reason)
Pain in the chest, abdomen, or bones (for no known reason)
Painless swelling in the lymph nodes
Skin rash or itchy skin
Weight loss (for no known reason)

Diagnostic Exams

Blood chemistry studies
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
MRI (magnetic reasonance imaging)
PET (positron emission tomography) scan

Progression and Transformation


Epidemiology and Mortality

Age: young or middle aged HIV patients
Sex: male predominance
Survival: <6 months


Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mature B-cell neoplasms
Pages: 323-324

International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes

National Cancer Institute
Section: General Information About Adult Non-Hodgkin Lymphoma (NHL)