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Tumoral nasopharyngeal lymphoid hyperplasia in human immunodeficiency virus-infected patients
E Oksenhendler1, H Lida, M F D'Agay
1Department of Hematology, St Louis Hospital, Paris, France.
Insights
Human immunodeficiency virus (HIV) infection can cause benign lymphoid hyperplasia in the nasopharynx, mimicking tumors. This condition presents as obstructive lesions but is not malignant.
Area of Science:
- Immunology
- Virology
- Pathology
Background:
- Nasopharyngeal lesions in human immunodeficiency virus (HIV)-infected individuals can be concerning for malignancy.
- Understanding the spectrum of HIV-associated conditions is crucial for accurate diagnosis and management.
Observation:
- Two HIV-1 infected men presented with large nasopharyngeal lesions causing obstructive symptoms.
- Initial presentation suggested a malignant tumor due to the size and location of the lesions.
Findings:
- Histologic examination revealed benign lymphoid follicular hyperplasia, not cancer.
- Immunohistochemistry confirmed a polyclonal lymphoid proliferation.
- Genetic studies ruled out immunoglobulin or T-cell receptor gene rearrangements.
- Epstein-Barr virus (EBV) DNA was not detected in one specimen, excluding a common viral association.
Implications:
- This case highlights diffuse extranodal lymphoid hyperplasia as a potential manifestation of HIV infection.
- It underscores the importance of considering benign conditions in the differential diagnosis of nasopharyngeal masses in HIV patients.
- Accurate diagnosis prevents unnecessary aggressive treatment for a non-malignant condition.
Abstract:
Two patients presented with a large tumoral nasopharyngeal lesion with obstructive symptoms, which suggested a malignant tumor. They were black men of Caribbean origin who were infected with human immunodeficiency virus 1. In both cases, histologic examination revealed intense but benign lymphoid follicular hyperplasia, and immunohistochemical studies were consistent with its polyclonal nature. DNA studies performed on tumoral tissue failed to disclose immunoglobulin or T-cell receptor gene rearrangements. In one biopsy specimen, DNA hybridization using Epstein-Barr virus-specific probes showed no evidence of Epstein-Barr virus-DNA sequences. The nasopharynx can be involved in the diffuse extranodal lymphoid hyperplasia associated with human immunodeficiency virus infection.