Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
UNUSUAL PRESENTATIONS OF NON-HODGKIN'S LYMPHOMAS IN HOMOSEXUAL MALES
Dev Oncol; 32:261-7 1985. Unique Identifier : AIDSLINE ICDB/87629335 Riggs SA; Kalter S; Cabanillas F; Hagemeister FB; Velasquez WS; Barlogie B; Salvador P; Mansell P; Hersh E; Butler J; Dept. of Hematology, Univ. of Texas M.D. Anderson Hosp. and Tumor; Inst., Houston, TX
Abstract:
Unusual presentations of non-Hodgkin's lymphomas were studied in 15 homosexual males with non-Hodgkin's lymphoma: 5 had diffuse large cell lymphoma (DLC), 6 had diffuse undifferentiated lymphoma (DUL) of either the Burkitt's or non-Burkitt's type, 1 had unclassifiable lymphoma, 1 had well-differentiated lymphocytic lymphoma (WDLL), and 2 had nodular poorly differentiated lymphocytic lymphoma (NPDL). Fourteen patients (pts) had advanced disease. Unusual sites of extranodal involvement were seen in all groups of pts, including primary brain DLC, tonsillar DUL, and WDLL of the earlobes. The median age of the 15 pts was 36 yr. Four of the DLC pts had acquired immune deficiency syndrome (AIDS), based on a history of opportunistic infections including Candida and Toxoplasma brain abscess, Cryptosporidium intestinal infection, Candida esophagitis, and Pneumocystis pneumonia. The diagnosis of AIDS in one DLC pt was based on primary CNS lymphoma alone, and two DUL pts were later classified as having AIDS when they developed Kaposi's sarcoma. The remainder of DUL pts and one with unclassified lymphoma had AIDS-related complex (ARC), defined as the presence of certain clinical and laboratory parameters indicative of an immunocompromised state, occurring in any individual at high risk for development of AIDS. Three remaining pts had neither AIDS nor ARC. Immunologic testing revealed a decreased number of helper T lymphocytes, inverted helper-suppressor T-cell ratios, and decreased delayed hypersensitivity in all pts tested. The lymphoma tissues of all 15 pts had the appearance of B-cell neoplasms. All DLC pts demonstrated poor treatment tolerance, with no complete remission documented, and all died within 5 mo of diagnosis. In contrast, 5/6 pts with DUL achieved complete remissions and three remained free of active lymphoma at 14, 14, and 30 mo. All showed excellent tolerance of intensive combination chemotherapy. Four pts with unclassifiable lymphoma, WDLL, and NPDL were alive at time of report with remissions lasting 8, 27, 30, and 52 mo; they were also tolerating combination chemotherapy well. (12 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY Antineoplastic Agents, Combined/THERAPEUTIC USE Brain Neoplasms/COMPLICATIONS/PATHOLOGY *Homosexuality Human Immunoglobulin Fragments/ISOLATION & PURIF Lymphoma, Non-Hodgkin's/COMPLICATIONS/DRUG THERAPY/IMMUNOLOGY/ *PATHOLOGY Male Neoplasm Metastasis Opportunistic Infections/COMPLICATIONS MEETING PAPER
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Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.
