Background. CD30 (Ki‐1) positive anaplastic large cell lymphoma (ALCL) has been only rarely described in HIV‐positive patients.
Methods. The clinicopathologic features of eight ALCLs occurring in four AIDS and four HIV‐positive patients were investigated. The phenotype of each neoplasm was determined by immunohistochemical methods. In three cases fresh tissue was available for molecular analysis.
Results. The ALCLs are a clinically heterogeneous group of T (4), B (1) and indeterminate (3) cell malignant lymphomas which presented in the skin (4), liver (1), lung (1), nasal cavity (1; also with bone marrow involvement) and peritoneal fluid (1). While most of the patients had aggressive disease, dying in a median of three months, two patients had either localized or regressing skin lesions. Molecular studies showed that two ALCLs, one of B cell and one of indeterminate cell lineage, contained clonal Epstein‐Barr virus sequences. None of the ALCLs examined contained evidence of HTLV‐1 or HIV integration nor did they exhibit c‐myc or bcl‐2 proto‐oncogene rearrangements. No mutations or deletions of the p53 tumor suppressor gene were identified in the three cases studied.
Conclusions. HIV‐related ALCL represents a clinically heterogeneous group of T cell, B cell and null cell malignant lymphomas, distinct from the previously described categories of AIDS‐associated NHL, that may expand the spectrum of lymphoid neoplasms associated with HIV‐infection. Identification and investigation of other cases of HIV‐associated ALCL is important to determine the nature of the relationship between HIV infection and the development of ALCL.
Background. This article reviews the salient pathologic and clinical features of 171 patients with Stage III‐IV disease who were 60 years of age or older who were treated on four Hodgkin disease (HD) protocols from 1969 to 1988.
Methods. Pretherapy sections were reviewed centrally for correlation of the histologic classification with anatomic sites of involvement and survival.
Results. The diagnosis of HD was confirmed in 114 (66.7%) patients. Non‐Hodgkin lymphomas (NHL) and a miscellaneous non‐HD group accounted for 52 (30.4%) and 5 (2.9%) of the cases. The overall median survival times of patients with Stage III‐IV HD and NHL who were 60 years of age or older in the four protocols were not significantly different (1.5 versus 1.3 years, respectively; P = 0.28). There also was no significant correlation between the survival of these patients with HD and either the Rye classification, 19 specific histologic parameters, or the British National Lymphoma Investigation grading system for HDNS. In the last protocol, the 5‐year survival rate of patients with HD who were 60 years of age or older was lower than that of patients 40–59 years of age or that of those younger than 40 years of age (31% versus 63% versus 79%, respectively, P < 0.0001). Patients with HD entered into the two most recent protocols showed lower incidences of involvement of cervical and iliac‐inguinal‐femoral lymph nodes and skin‐subcutaneous tissues than the patients with NHL who were mis‐diagnosed as HD. Moreover, patients with Stage III‐IV HD in the most recent protocol who were 60 years of age or older had lower rates of involvement of the cervical and mediastinal‐hilar lymph nodes and a higher rate of involvement of the gastrointestinal tract than younger patients.
Conclusions. Patients with Stage III‐IV HD and NHL who are 60 years of age or older differ with respect to the rates of involvement of specific anatomic sites but not in survival when treated with HD protocols. In contrast, patients of different age groups with Stage III‐IV HD disease differ with regard to the rates of involvement of anatomic sites and survival.
An osteogenic sarcoma occurring in a 22‐year‐old woman was found to be associated with production of a large amount of beta human chorionic gonadotrophin (B‐hCG). Pregnancy was excluded on the basis of a normal ultrasonogram and a proliferative type endometrium obtained by curettage. A homogenate of the tumor was strongly positive for B‐hCG while immunohistochemical staining of the tumor cells was strongly positive for B‐hCG and negative for pregnancy associated glycoprotein. These results indicate ectopic production of hCG by the osteosarcoma.
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