Lymphoproliferative Lesions in the Setting of HIV Infection: A Five-Year Retrospective Case Series and Review

Abstract

A wide variety of noninfectious lesions have been identified in association with HIV infection. Many hematolymphoid lesions are possible in this patient group, both reactive and neoplastic. Epidemiologic data suggests that lymphoid malignancies are among the most common neoplasms in patients with HIV. We present a selective case series assembled over a 5-year period from the relatively low HIV-prevalence Hamilton Regional Laboratory Medicine Program (HRLMP), a tertiary care referral centre in Southern Ontario. This series serves to demonstrate the wide variety of lymphoid lesions that may be encountered in patients with HIV. In addition to outlining the pathologic work-up necessary in these cases, we discuss characteristics that distinguish the HIV-associated lesions from the pathobiologically similar non-HIV-associated lymphoid lesions.

Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa

“…In Grade 2 there is a reduction in lymphoid follicles and mature lymphocytes, but an increase in plasma cells and perifollicular blood vessels. In Grade 3, the germinal centres become sclerotic [ 19 ].…”

Epstein-Barr virus-positive mucocutaneous ulcer colliding with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (malt lymphoma) that developed in the palatine tonsils of an immunocompetent patient after gastric lymphoma relapse

“…Many of these cells are atypical and have Hodgkin and Reed-Sternberg-like morphology that may be of concern to histopathologists. These B lymphocytes show co-expression of CD30 in keeping with an activated phenotype and are entirely positive for EBER-ISH [56]. Due to its good response to conservative measures, especially showing an indolent behavior and a self-limited clinical course, this condition should be distinguished from high-grade neoplastic B-cell proliferations, such as extranodal classical Hodgkin's lymphoma and EBV-associated diffuse large B-cell lymphoma, typically seen in elderly patients.…”

Malaria, Epstein–Barr virus infection and the pathogenesis of Burkitt's lymphoma

“…HIV infection is estimated to increase the likelihood of developing a lymphoma by 60 to 110‐fold; moreover, HIV/AIDS‐related lymphomas are predominantly B‐cell lymphomas. Burkitt's lymphoma is 1000 times more common in HIV patients than in the general population and accounts for up to 40% of HIV‐associated lymphomas . The pathogenesis of HIV and the cause of the decline in CD4 T cells remain obscure.…”

“…Burkitt's lymphoma is 1000 times more common in HIV patients than in the general population and accounts for up to 40% of HIV-associated lymphomas. 60 The pathogenesis of HIV and the cause of the decline in CD4 T cells remain obscure. Although some studies suggest that vitamin A supplementation is associated with disease improvement, others with disease worsening, 61 dietary intake of vitamin A (and of niacin and zinc) was reported to be significantly associated with progression from HIV to acquired immunodeficiency syndrome (AIDS).…”