LYMPHOID PROLIFERATIONS ASSOCIATED WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

LYMPHOID PROLIFERATIONS ASSOCIATED WITH THE ACQUIRED IMMUNODEFICIENCY SYNDROME

Molecular Genetics in Cancer Diagnosis. Cossman J, ed. New York, Elsevier, p. 249-72, 1990.. Unique Identifier : AIDSLINE ICDB/91676255
Knowles DM; Dalla-Favera R; Coll. of Physicians and Surgeons of Columbia Univ., New York, NY

Abstract: Malignant lymphomas occurring in association with AIDS are a significant and challenging clinical problem, primarily because of their distinctive clinicopathologic features. AIDS-associated lymphoid neoplasia was investigated in New York City. Medical records were screened to identify all patients (pts) seen between January 1981 and December 1986 who had AIDS, AIDS-related complex (ARC), or increased risk for contracting AIDS who developed a pathologically documented lymphoid neoplasm. Fresh, unfixed representative samples of lymph node and other tissues, peripheral blood, and aspirated bone marrow exhibiting pathological involvement by malignant lymphoid neoplasia were obtained. Clinical, pathologic, and immunophenotypic characteristics of this population are described and the following topics are reviewed: antigen receptor gene rearrangement analysis of AIDS-associated lymphoid neoplasia; role of retroviruses in the pathogenesis of AIDS-associated lymphoid neoplasia; role of the Epstein-Barr virus (EBV) in pathogenesis of AIDS-associated B-cell non-Hodgkin's lymphoma (NHL); role of c-myc oncogene activation in the pathogenesis of AIDS-associated B-cell NHL; and relationship between AIDS-associated hyperplastic lymphadenopathy and B-cell NHL. Persons with AIDS, persons with ARC, and those at increased risk of developing AIDS have a greatly increased incidence of lymphoid neoplasia. The vast majority of the lymphoid neoplasms are B-cell NHLs, but some pts also develop atypical, aggressive Hodgkin's disease and, rarely, T-cell chronic lymphocytic leukemia. Most pts with AIDS-associated NHL present with widely disseminated disease, which frequently involves extranodal sites. Nearly all AIDS-associated NHLs belong to one of three major histopathologic categories: small noncleaved cell, large cell immunoblastic, plasmacytoid, and large noncleaved cell lymphomas. Approx 90% of AIDS-associated NHLs express B-cell immunophenotypes including expression of monotypic surface Ig and/or the B cell-associated antigen CD20 (B1) and absence of T cell-associated antigens. Approx 10% of AIDS-associated NHLs lack B- and T-cell-lineage restricted antigens. HIV appears not to be involved directly in the pathogenesis of AIDS-associated lymphoid neoplasia, because HIV DNA sequences could not be detected in AIDS-associated lymphoid neoplasms. EBV, however, may be involved in the pathogenesis of up to one third of AIDS-associated B-NHLs. (69 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*DIAGNOSIS/GENETICS Adult Aged Cell Transformation, Neoplastic/GENETICS Cell Transformation, Viral/GENETICS Female Gene Expression Regulation, Neoplastic/PHYSIOLOGY Gene Expression Regulation, Viral/PHYSIOLOGY Gene Rearrangement, beta-Chain T-Cell Antigen Receptor/GENETICS Gene Rearrangement, B-Lymphocyte, Heavy Chain/GENETICS Herpesvirus 4, Human/*GENETICS Hodgkin's Disease/DIAGNOSIS Human HIV/*GENETICS HTLV-I/*GENETICS Lymph Nodes/PATHOLOGY Lymphoma/*DIAGNOSIS/GENETICS Lymphoma, Non-Hodgkin's/DIAGNOSIS Male Middle Age MONOGRAPH
912130
M91C4101

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