Rubin M, Bagg A, Cossman J; International Conference on AIDS.

Int Conf AIDS. 1993 Jun 6-11; 9: 403 (abstract no. PO-B13-1609).

Department of Pathology, Georgetown University Hospital, Washington, D.C.

An increased incidence of non-Hodgkin's Lymphoma (NHL) has been well documented in HIV+/AIDS patients. By far the majority of these NHLs are of high grade histology, with an associated aggressive clinical course. We describe a 38 year old homosexual male with AIDS since 1984 who developed a follicular NHL, an extremely unusual form of NHL occurring in this setting. Immunophenotypic analysis by flow cytometry revealed that the lymphoma cells were clonally-restricted B-cells (CD19+, CD20+, CD22+, IgM-Kappa+). The monoclonal nature of these cells was confirmed by an assessment of the immunoglobulin heavy chain gene configuration. Additional molecular genetic analysis failed to reveal bcl-2 gene rearrangements at both mbr and mcr loci, the c-myc gene (3'-region) was in a germline configuration and no EBV genome could be detected by PCR analysis of the LTR region. A number of unusual features are apparent. First, the occurrence of follicular NHL in this setting is most unusual; while it is possible that this lymphoma is a coincidental phenomenon, the presentation in a relatively young patient is somewhat unusual. Furthermore, translocations involving the bcl-2 gene locus are seen in the majority of NHLs with a follicular histology but have not been reported in AIDS-associated lymphomas. No rearrangement was seen at the two commonest areas of breakage in this patient's NHL. Second, AIDS-associated NHLs resemble endemic Burkitt's lymphomas in that they have a c-myc gene translocation and the presence of Epstein-Barr virus DNA sequence (this finding is, however, controversial). In this case, neither the Epstein-Barr virus DNA sequence nor a c-myc rearrangement were found. Thus, while it remains unclear as to whether this NHL (unusual in HIV-positive patients) was coincidental or associated with the patient's immunodeficiency, oncologists and pathologists need to be aware of the possibility that low and intermediate grade lymphomas may arise in AIDS/HIV patients.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• B-Lymphocytes
• Genes, Immunoglobulin
• Genes, bcl-2
• Genes, myc
• HIV
• HIV Seropositivity
• Herpesvirus 4, Human
• Humans
• Incidence
• Lymphoma, AIDS-Related
• Lymphoma, Follicular
• Lymphoma, Non-Hodgkin
• Male
• Proto-Oncogene Proteins c-myc
• Translocation, Genetic
• genetics
• immunology

Other ID:

• 93335175

UI: 102204552

From Meeting Abstracts