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AIDS-related lymphomas: from pathogenesis to pathology.
Antonino Carbone1, Annunziata Gloghini
1Department of Pathology, Istituto Nazionale Tumori, Milano, Italy. antonino.carbone@istitutotumori.mi.it
British Journal of Haematology
|August 24, 2005
Summary
Human immunodeficiency virus (HIV)-associated lymphomas encompass common types like Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL), alongside rare HIV-specific lymphomas such as primary effusion lymphoma (PEL). These lymphomas exhibit diverse molecular and biological features.
Area of Science:
- Oncology
- Virology
- Pathology
Background:
- Human immunodeficiency virus (HIV) infection is associated with a range of lymphomas, broadly categorized into those also seen in HIV-negative individuals and those specific to HIV-positive patients.
- HIV-associated lymphomas exhibit significant pathological and molecular heterogeneity, reflecting diverse underlying genetic and viral influences.
- Key molecular lesions include cMYC activation, P53 inactivation, and Epstein-Barr virus (EBV) or Kaposi's sarcoma-associated herpesvirus/human herpesvirus 8 (KSHV/HHV8) infections.
Purpose of the Study:
- To delineate the spectrum of lymphomas associated with HIV infection.
- To describe the distinct pathological and molecular characteristics of different HIV-associated lymphoma subtypes.
- To highlight the role of viral co-infections, such as EBV and KSHV/HHV8, in the pathogenesis of these lymphomas.
Main Methods:
- Review of pathological and molecular data from HIV-associated lymphomas.
- Classification of lymphomas based on occurrence in HIV-positive versus HIV-negative individuals.
- Analysis of molecular lesions, including viral associations and genetic alterations.
Main Results:
- HIV-associated lymphomas include high-grade B-cell lymphomas (BL, DLBCL) and rare entities like primary effusion lymphoma (PEL) and plasmablastic lymphoma.
- AIDS-BL involves cMYC activation, P53 inactivation, and EBV infection.
- AIDS-immunoblastic lymphoma (IBL) shows frequent EBV latent membrane protein 1 expression.
- KSHV/HHV8-associated lymphomas, predominantly PEL, occur in advanced AIDS and can present as solid extracavitary lymphomas with PEL-like morphology.
Conclusions:
- HIV-associated lymphomas are pathologically and biologically heterogeneous.
- Specific molecular lesions and viral associations (EBV, KSHV/HHV8) characterize different subtypes.
- Understanding this heterogeneity is crucial for diagnosis and potentially for targeted therapies.