AIDS-related lymphomas: evaluation by abdominal CT

Recent evidence indicates that individuals with acquired immunodeficiency syndrome (AIDS) or those at high risk for AIDS have an increased occurrence of lymphoma. AIDS-related lymphomas (ARLs) often present with an advanced stage of disease and highly malignant histologic subtypes. This study reviewed the abdominal computed tomographic (CT) findings in 29 patients with ARL, including ten with Hodgkin disease (HD) and 19 with non-Hodgkin lymphoma (NHL). Focal splenic and hepatic involvement was more common in both AIDS-related HD (10%) and NHL (26%) than reported in the non-AIDS population. In addition, mesenteric lymphadenopathy was demonstrated in 20% of patients with AIDS-related HD, compared with less than 5% in non-AIDS patients. In this series, patients with NHL had pelvic nodal masses in 37%, bowel involvement in 26%, and renal lesions in 11%. The authors conclude that ARLs are highly aggressive neoplasms that often present with atypical features compared with lymphomas in other patients. Potential problems in the CT interpretation of ARL for homosexual men are discussed.