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Related Experiment Videos

Primary lymphomatous effusions in AIDS: a morphological, immunophenotypic, and molecular study

I Green1, E Espiritu, M Ladanyi

  • 1Department of Pathology, New York University Medical Center, New York, USA.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|January 1, 1995
PubMed
Summary

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This study identifies a unique subtype of high-grade lymphoma in human immunodeficiency virus-positive (HIV+) patients, often presenting in body cavities and characterized by a predominant null immunophenotype and immunoblastic morphology, differing from typical HIV-associated lymphomas.

Area of Science:

  • Oncology
  • Virology
  • Immunology

Background:

  • Lymphomas in human immunodeficiency virus-positive (HIV+) patients often present with unique characteristics.
  • Understanding these distinct lymphoma subtypes is crucial for diagnosis and treatment in immunocompromised individuals.

Purpose of the Study:

  • To characterize a specific subgroup of high-grade lymphomas found in body effusions of HIV+ patients.
  • To compare the immunophenotype and genetic features of these lymphomas with other HIV-associated lymphomas and non-HIV lymphomas.

Main Methods:

  • Analysis of cytological subtypes, immunophenotype (using flow cytometry markers), and genetic rearrangements (Ig heavy-chain, Epstein-Barr virus, MYC) in 18 HIV+ patients with lymphomas in pleural effusions or ascites.
  • Comparison of findings with previously studied HIV+ lymphomas and lymphomas in HIV-negative patients.

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Main Results:

  • 18 HIV+ patients presented with lymphomas in body effusions, often as initial presentation (13/15).
  • Predominant subtypes were large cell immunoblastic (n=7) and anaplastic large cell (n=6).
  • A high incidence (83%) of null immunophenotype was observed, contrasting sharply with HIV+ tissue lymphomas (9%) and non-HIV lymphomas (0%).
  • Seven lymphomas expressed CD30; genetic analysis revealed Ig heavy-chain gene rearrangement in 4/5 null phenotype cases, EBV integration in 2 cases, and no MYC rearrangement.

Conclusions:

  • This study describes a distinct subgroup of high-grade HIV-associated lymphomas.
  • These lymphomas are characterized by body cavity presentation, immunoblastic morphology, a high prevalence of null immunophenotype, and frequent CD30 expression.
  • The findings suggest these lymphomas arise in profound immunosuppression and differ genetically from other HIV-associated lymphomas, notably lacking MYC rearrangement.