CD30 (Ki-1) positive anaplastic large cell lymphomas in individuals infected with the human immunodeficiency virus

Abstract

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.

Human Herpesvirus 8–Associated Solid Lymphomas that Occur in AIDS Patients Take Anaplastic Large Cell Morphology

“…There have been approximately 30 cases of AIDS-ALCL reported (2)(3)(4)(5)(6). In those reports, the term "ALCL" was used in a broad sense, based mostly on morphology.…”

“…Approximately 30 reported cases have used the term "AIDS-associated anaplastic large cell lymphomas (AIDS-ALCLs)" under the somewhat ambiguous definition of ALCL (2-6). Such AIDS-ALCLs were reported to occur much more frequently in extranodal organs, including the skin, lung, liver, bone marrow, and gastrointestinal tract (2)(3)(4)(5)(6). Their clinical courses were less favorable than the other AIDS-associated lymphomas.…”

“…Their clinical courses were less favorable than the other AIDS-associated lymphomas. Indeed, the immunophenotype of these reported AIDS-ALCLs was confusing: Chadburn et al (2) reported 10 cases of AIDS-ALCLs in which were included 4 T-cell, 1 B-cell, and 3 null-cell type lymphomas, whereas many of the cases reported by Nosari et al (2)(3)(4)(5)(6). ALCL is a subtype of non-Hodgkin's lymphoma (NHL) characterized by its peculiar, large anaplastic morphology and the expression of CD30 (7,8).…”

Primary pulmonary lymphoma

“…It is reminiscent of high-grade pleural NHL in acquired immune deficiency syndrome (AIDS) patients [60,65] and in patients with pleural sequelae of collapsotherapy. Epstein-Barr virus (EBV) has been implicated in the onset of some of these highgrade NHL affecting the lung [62,63,[65][66][67][68]. Excluding HIV-infected subjects, mean age at onset is y60 yrs (30-80 yrs) [5,9,10,15,24].…”

Development of CD30+ lymphoproliferative disease in mice lacking interferon regulatory factor-1

“…CD30 is also expressed on mitogen-activated (Hsu and Hsu, 1990;Bashir et al, 1992;Wendtner et al, 1995) and virally infected lymphocytes, such as HIV (Carbone et al, 1991;Gonzalez-Clemente et al, 1991;Chadburn et al, 1993;Nosari et al, 1996) and HTLV I infected T cells (Anagnostopoulos et al, 1990). CD30 expression is apparently more strongly, though by no means exclusively, associated with the Th2 response (Del Prete et al, 1995a, b), but there is no known role of CD30 expression specific to the Th2 response.…”