1
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Affiliation(s)
- A Aggarwal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - A Mittal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - A Sasi
- Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - N Nischal
- Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
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2
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da Silva Nascimento J, Sérgio Ramos de Araújo P, Romão de Souza Júnior V, Lopes de Melo F, Sá Araújo Lins Carvalho D, Magalhães V. HIV-related lymphomas in adults served in the public health network: An observational study. Medicine (Baltimore) 2019; 98:e16129. [PMID: 31261533 PMCID: PMC6617433 DOI: 10.1097/md.0000000000016129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Individuals infected with human immunodeficiency virus (HIV) have higher morbidity and mortality due to cancer, which is the third most common cause of death in this group, despite the high effectiveness of antiretroviral therapy (ART). We describe the clinical and laboratory characteristics, initial staging and outcome of HIV-related lymphoma.We included 18 patients in the study, of whom 61.1% were male, mean age 41 years. Nine of the 18 patients (50%) had a diagnosis of HIV infection concurrent with the diagnosis of lymphoma.The most common histological types were diffuse non-Hodgkin B-cell lymphoma, 8 patients (44.4%); and Burkitt lymphoma, 5 (27.8%) cases. The Cotswold revision of the Ann Arbor staging classification in 14 patients (77.7%) was between III and IV. B Symptoms were present in 11 patients (61.1%), bulky mass was observed in 11 cases (61.1%) and had extra-nodal involvement in 8 patients (44.4%).Of the 18 cases analyzed, 8 followed on to second-line treatment, wherein the CODOX-M/IVAC scheme (cyclophosphamide, adriamycin, vincristine, methotrexate/ifosfamide, etoposide, and cytosine arabinoside) was used in 3 of the cases. The second most common scheme was etoposide, doxorubicin, vincristine and cyclophosphamide (EPOCH), used in 2 cases (25%), while in single cases (12.5% each) cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone (CHOEP), ifosfamide, etoposide, and carboplatin (ICE) and dexamethasone, cisplatin, and cytarabine (DHAP) were used.In this series, we observed very high mortality, equivalent to 44.4%, and a complete response in only 11.1%, much lower than that observed by other authors.We found that patients diagnosed with lymphoma associated with HIV had an advanced early clinical staging, and evolved with low response rates to chemotherapy.
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Affiliation(s)
- Janaíra da Silva Nascimento
- Service of Onco-Hematology of Pernambuco Cancer
- Foundation of Hematology and Hematology of Pernambuco
- Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Fábio Lopes de Melo
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation
- Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Vera Magalhães
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation
- Universidade Federal de Pernambuco, Recife, Brazil
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3
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De la Cruz-Hernández I, Mejía-Martínez JC, Soberanes-Cerino CDJ, Mejía-Picasso CA. [Burkitt's lymphoma nodular cystic hepatosplenic, in HIV patient. Case report]. Rev Med Inst Mex Seguro Soc 2019; 57:187-190. [PMID: 31995346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Patients with human immunodeficiency virus (HIV) are more likely to develop cancer. Malignant lymphomas are the main cancer group seen in these patients. Diffuse large B-cell lymphoma including central nervous system lymphoma and Burkitt's lymphoma account for 90% of HIV-related non-Hodgkin's lymphomas. CLINICAL CASE A 22-year-old man with fever up to 39 ° C, malaise, excessive tiredness and night sweats, loss of 8 kg of weight, abdominal pain in the right hypochondrium, all 5 months before hospitalization. Hemoglobin: 9.5 g/dL, leukocytes 5.13 x 103/mm3, platelets 124 000 cel/mm3; albumin 2.9 g/dL, alanine aminotransferase 28 IU/L, aspartate aminotransferase 105 IU/L; HIV reactive, beta 2 microglobulin: 20 000 ng/mL. Viral load for HIV 100 034 cp/mL, CD4: 76 cel/mcL (5%). It was performed abdominal ultrasound and denoted cysts in the liver and spleen. Abdominal-pelvic computed tomography with hepatosplenomegaly, retroperitoneal and inguinal adenopathies and free fluid in abdominal cavity. Splenectomy was performed and Burkitt's lymphoma was reported in the histopathological study. CONCLUSION HIV predisposes patients to any type of cancer. Intra-abdominal findings should be a warning of lymphoma suspicious and may occur from infiltration of the small intestine, solid organ and soft tissues.
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Affiliation(s)
- Ibis De la Cruz-Hernández
- Instituto Mexicano del Seguro Social. Hospital General de Zona No. 2. Servicio de Medicina Interna. Cárdenas, Tabasco, México
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4
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Puzyreva LV, Safonov AD. [INFECTIONS CAUSED BY EPSTEIN-BARR VIRUS IN HIV-INFECTED PATIENTS]. Zh Mikrobiol Epidemiol Immunobiol 2016:108-116. [PMID: 30695397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The review is dedicated to features of clinical manifestations of infections caused by Epstein- Barr virus (EBV) in HIV-infected patients, problems of diagnostics and execution of antiviral therapy in the case of combination of these infections. Individuals at AIDS stage develop tumors, associated with EBV: non-Hodgkin's lymphomas, including Berkitt's,lymphoma, primary B-cell lymphoma,of CNS, nasopharyngeal carcinoma. Formation of lymphoid interstitial pneumonitis and leukoplakia is known to be associated with EBV. A large list of preparations that are inhibitors of EBV replication are currently known, however, there is no clear pathogenetically justified therapy scheme for patients with this infection against the background of HIV-infection.
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5
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Basavaraj A, Kadam M, Kadam DB. Primary Maxillary Sinus Plasmablastic Lymphoma in HIV/AIDS. J Assoc Physicians India 2016; 64:71-72. [PMID: 27735156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Classically, the HIV/AIDS-related lymphomas are of the B cell type and involve the central nervous system and the abdominal cavity. Primary maxillary sinus lymphoma is rare. Plasmablastic lymphoma (PBL) is an aggressive form of non-Hodgkinvs lymphoma, and is extremely rare. Here we present a case of plasmablastic lymphoma with primary site being maxillary sinus, a rare location.
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Affiliation(s)
| | | | - D B Kadam
- Professor and Head, Department of Medicine, Sassoon General Hospital, Pune, Maharashtra
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6
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Arbune M, Georgescu CV, Voinescu DC. AIDS-related lymphoma in a young HIV late presenter patient. Rom J Morphol Embryol 2016; 57:273-276. [PMID: 27151720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Non-Hodgkin's lymphoma (NHL) is an acquired immunodeficiency syndrome (AIDS)-indicative disease. Nowadays, NHL is rarely reported in Europe as indicative disease for human immunodeficiency virus (HIV) testing. We present the case of a 22-year-old Romanian male patient without past medical history, except the swelling of a submental lymph node 11 months ago. The excised node was histologically examined but the patient neglected to take his result. He was admitted for fever, asthenia, and weight loss over 10% of his weight, and night sweats in the last four months. The immunohistochemical analysis of the preserved lymph node samples suggested reactive hyperplasic lymphadenitis with suppuration and necrosis (lymphoid follicles CD20+, CD10+, BCL6+; germinal centers CD23+, CD68+, Ki67+; and interfollicular CD3+). Clinical, biological and imaging evaluations were performed. The diagnostic of lymphoma stage IV Ann Arbor was sustained. Severe immunosuppression and a positive HIV test were found. The patient received antiretroviral treatment, but he developed paraplegia consecutive to a vertebral metastasis, liver and kidney failure and died sooner than two months from the diagnostic time. Pathological examination confirmed NHL with diffuse lymphocyte infiltrate of multiple organs. Advanced lymphoma is a rare indicator condition of HIV diagnostic. Delayed diagnostic of lymphoma implies ethical issues on communication deficiencies between the heath providers and patients, concerning the significance of biopsy. Infectious co-morbidities with necrosis and suppurative lesions are confounder conditions in NHL histological and immunohistochemical diagnosis.
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Affiliation(s)
- Manuela Arbune
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, "Lower Danube" University of Galati, Romania;
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7
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Affiliation(s)
- G Gaidano
- Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, N.Y
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Luria L, Nguyen J, Zhou J, Jaglal M, Sokol L, Messina JL, Coppola D, Zhang L. Manifestations of gastrointestinal plasmablastic lymphoma: A case series with literature review. World J Gastroenterol 2014; 20:11894-11903. [PMID: 25206297 PMCID: PMC4155383 DOI: 10.3748/wjg.v20.i33.11894] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 03/22/2014] [Accepted: 05/26/2014] [Indexed: 02/06/2023] Open
Abstract
Plasmablastic lymphoma (PBL) rarely occurs in the gastrointestinal (GI) tract with limited studies reported. We reviewed the clinical histories and pathology of four patients with GI PBL at our institute and similar case reports published in peer-reviewed journals. In our first case, a 40 year-old human immunodeficiency virus positive male presented with a hemorrhoid-like sensation, and was diagnosed with PBL via biopsy of a rectal mass. The second case involves a 65 year-old healthy male with bloody diarrhea who was found to have PBL in a resected sigmoid mass. The third patient was a 41 year-old male with a history of Crohn’s disease who presented with abdominal pain, diarrhea, and weight loss. A small intestinal mass (PBL) was removed. The fourth patient was a 65-year-old male who was found PBL after surgical resection of bowel for his florid Crohn’s disease. He later developed secondary acute myeloid leukemia. Clinical outcome was very poor in 3 out of 4 patients as reported in the literature. One patient survived chemotherapy followed by autologous transplant. The prototypical clinical presentation and variations of PBL can help create a more comprehensive differential diagnosis for GI tumors and establish an appropriate therapeutic guideline.
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Yamada M, Katano H, Yotsumoto M, Hashimoto H, Muramatsu T, Shiotsuka M, Fukutake K, Kuroda M. Unique expression pattern of viral proteins in human herpesvirus 8-positive plasmablastic lymphoma: a case report. Int J Clin Exp Pathol 2014; 7:6415-6418. [PMID: 25337302 PMCID: PMC4203273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 08/20/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Human herpesvirus 8 (HHV8)-positive plasmablastic lymphoma is a disease which correlates with acquired immunodeficiency syndrome (AIDS). Little is known about the pathogenesis of the disease due to its rarity. We report an autopsy case about AIDS related HHV-8-positive plasmablastic lymphoma and presents an examination about HHV8 related proteins for the disease by using immunohistochemical techniques. CASE PRESENTATION Two kinds of tumors complicated the male AIDS patient: one was HHV-8-positive plasmablastic lymphoma and the other was Kaposi's sarcoma (KS). Immunohistochemically, the lymphoma cells were positive for HHV8-associated lytic early proteins as well as HHV8 latency-associated nuclear antigen 1 (LANA-1), and, on the other hand, the lymphoma cells were negative for lytic immediately early proteins. KS was positive for only LANA-1. CONCLUSION These findings indicate that the lymphoma cells acquired an ability to proliferate without de novo HHV8 replication. Moreover, the onset mechanisms of HHV-8-positive plasmablastic lymphoma may be different from those of KS.
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MESH Headings
- Antigens, Viral/analysis
- Autopsy
- Basic-Leucine Zipper Transcription Factors/analysis
- Biomarkers, Tumor/analysis
- Castleman Disease/immunology
- Castleman Disease/pathology
- Castleman Disease/virology
- Cell Proliferation
- Fatal Outcome
- Herpesvirus 8, Human/immunology
- Herpesvirus 8, Human/pathogenicity
- Host-Pathogen Interactions
- Humans
- Immediate-Early Proteins/analysis
- Immunohistochemistry
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Male
- Middle Aged
- Nuclear Proteins/analysis
- Repressor Proteins/analysis
- Sarcoma, Kaposi/immunology
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Trans-Activators/analysis
- Ureteral Neoplasms/immunology
- Ureteral Neoplasms/pathology
- Ureteral Neoplasms/virology
- Viral Proteins/analysis
- Virus Replication
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Affiliation(s)
- Masatoshi Yamada
- Department of Molecular Pathology, Tokyo Medical UniversityTokyo, Japan
| | - Harutaka Katano
- Department of Pathology, National Institute of Infectious DiseaseTokyo, Japan
| | - Mihoko Yotsumoto
- Department of Laboratory Medicine, Tokyo Medical University HospitalTokyo, Japan
| | | | - Takashi Muramatsu
- Department of Laboratory Medicine, Tokyo Medical University HospitalTokyo, Japan
| | - Mika Shiotsuka
- Department of Laboratory Medicine, Tokyo Medical University HospitalTokyo, Japan
| | - Katsuyuki Fukutake
- Department of Laboratory Medicine, Tokyo Medical University HospitalTokyo, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical UniversityTokyo, Japan
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10
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Basavaraj A, Shinde A, Kulkarni R, Kadam DB, Chugh A. HIV associated Burkitt's lymphoma. J Assoc Physicians India 2014; 62:723-727. [PMID: 25856946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Burkitt's lymphoma (BL) is a highly aggressive B-cell non-Hodgkin Lymphoma (NHL) associated with chromosomal translocations resulting in upregulation of the proto-oncogene C-MYC, which drives progression through the cell cycle NHL accounts for approximately one third of AIDS-related malignancies and the frequency of BL is 2.4-20% of HIV-associated NHL. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, still has poor outcome with standard chemotherapy. We present here a 26 years old female who presented with congestive cardiac failure and sudden onset paraparesis and was finally diagnosed to have right atrial mass and had extradural lesion extending from L2 to S1 which turned out to be High grade NHL-Burkitt's Lymphoma.
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11
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Sekar D, Hairul Islam VI, Thirugnanasambantham K, Saravanan S. Relevance of miR-21 in HIV and non-HIV-related lymphomas. Tumour Biol 2014; 35:8387-93. [PMID: 24961346 DOI: 10.1007/s13277-014-2068-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 05/06/2014] [Indexed: 12/11/2022] Open
Abstract
The critical role of microRNAs (miRNAs) in cell differentiation, homeostasis and cancer development has been extensively discussed in recent publications. The microRNAs with RISC enzyme complex allow it to find its complementary sequence, which is usually located in the 3'-untranslated region (UTR) of the target messenger RNA (mRNA). This is followed by inhibition of protein translation or promotion, resulting in degradation of the target gene. miR-21 has been mapped at chromosome 17q23.2, where it overlaps with the protein coding gene vacuole membrane protein 1 (VMP1), a human homologue of rat vacuole membrane protein. Recent evidence indicates that miR-21 plays a vital role in tumour cell proliferation, apoptosis and invasion. The inhibition of miR-21 may induce cell cycle arrest and increased chemosensitivity to anticancer agents, providing evidence that miR-21 functions as an oncogene in human cancer. Increased expression levels of miR-21 were observed in tumours arising from diverse tissue types. This also includes tumours of haematological origin, such as chronic lymphatic leukaemia, diffuse large B cell lymphomas (DLBCLs), acute myeloid leukaemia and Hodgkin lymphomas. Recently, it has been shown that high levels of B cell activation were induced by miR-21 in circulating B cells and are seen in HIV-infected individual. Notably, miR-21 is overexpressed in activated B cells, suggesting its assistance in maintaining B cell hyperactivation, which plays a pivotal role in HIV-infected cells. Therefore, miR-21 can be considered as a powerful biomarker in HIV-related lymphomas. The number of studies related to the role of miR-21 in HIV-related lymphomas is sparse; therefore, this mini review highlights the recent publications related to clinical impact and significance of miR-21, specifically in HIV- and non-HIV-related lymphomas.
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Affiliation(s)
- Durairaj Sekar
- Pondicherry Centre for Biological Sciences, Jawahar Nagar, Pondicherry, 605005, India,
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12
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Henao-Martínez AF, Gray JM, González-Fontal GR, Reves R. Intracardiac extra-cavitary primary effusion lymphoma in an HIV-infected patient. Int J STD AIDS 2014; 24:78-9. [PMID: 24400343 DOI: 10.1258/ijsa.2012.012178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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13
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Tanaka S, Nagata N, Mine S, Igari T, Kobayashi T, Sugihara J, Honda H, Teruya K, Kikuchi Y, Oka S, Uemura N. Endoscopic appearance of AIDS-related gastrointestinal lymphoma with c- MYC rearrangements: Case report and literature review. World J Gastroenterol 2013; 19:4827-4831. [PMID: 23922484 PMCID: PMC3732859 DOI: 10.3748/wjg.v19.i29.4827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Revised: 05/12/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the highly active anti-retroviral therapy (HAART) era. Recently, rearrangement of MYC is associated with poor prognosis in patients with diffuse large B-cell lymphoma. Here, we report a rare case of gastrointestinal (GI)-ARL with MYC rearrangements and coinfected with Epstein-Barr virus (EBV) infection presenting with various endoscopic findings. A 38-year-old homosexual man who presented with anemia and was diagnosed with an human immunodeficiency virus infection for the first time. GI endoscopy revealed multiple dish-like lesions, ulcerations, bloody spots, nodular masses with active bleeding in the stomach, erythematous flat lesions in the duodenum, and multiple nodular masses in the colon and rectum. Magnified endoscopy with narrow band imaging showed a honeycomb-like pattern without irregular microvessels in the dish-like lesions of the stomach. Biopsy specimens from the stomach, duodenum, colon, and rectum revealed diffuse large B-cell lymphoma concomitant with EBV infection that was detected by high tissue EBV-polymerase chain reaction levels and Epstein-Barr virus small RNAs in situ hybridization. Fluorescence in situ hybridization analysis revealed a fusion between the immunoglobulin heavy chain (IgH) and c-MYC genes, but not between the IgH and BCL2 loci. After 1-mo of treatment with HAART and R-CHOP, endoscopic appearance improved remarkably, and the histological features of the biopsy specimens revealed no evidence of lymphoma. However, he died from multiple organ failure on the 139th day after diagnosis. The cause of his poor outcome may be related to MYC rearrangement. The GI tract involvement in ARL is rarely reported, and its endoscopic findings are various and may be different from those in non-AIDS GI lymphoma; thus, we also conducted a literature review of GI-ARL cases.
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MESH Headings
- Adult
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antiretroviral Therapy, Highly Active
- Biopsy
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Endoscopy, Gastrointestinal
- Fatal Outcome
- Gastrointestinal Neoplasms/drug therapy
- Gastrointestinal Neoplasms/genetics
- Gastrointestinal Neoplasms/pathology
- Gastrointestinal Neoplasms/virology
- Gene Rearrangement
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/virology
- Predictive Value of Tests
- Prednisone/administration & dosage
- Proto-Oncogene Proteins c-myc/genetics
- Rituximab
- Time Factors
- Treatment Outcome
- Vincristine/administration & dosage
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Widney DP, Olafsen T, Wu AM, Kitchen CMR, Said JW, Smith JB, Peña G, Magpantay LI, Penichet ML, Martinez-Maza O. Levels of murine, but not human, CXCL13 are greatly elevated in NOD-SCID mice bearing the AIDS-associated Burkitt lymphoma cell line, 2F7. PLoS One 2013; 8:e72414. [PMID: 23936541 PMCID: PMC3732224 DOI: 10.1371/journal.pone.0072414] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 07/16/2013] [Indexed: 11/29/2022] Open
Abstract
Currently, few rodent models of AIDS-associated non-Hodgkin’s lymphoma (AIDS-NHL) exist. In these studies, a novel mouse/human xenograft model of AIDS-associated Burkitt lymphoma (AIDS-BL) was created by injecting cells of the human AIDS-BL cell line, 2F7, intraperitoneally into NOD-SCID mice. Mice developed tumors in the peritoneal cavity, with metastases to the spleen, thymus, and mesenteric lymph nodes. Expression of the chemokine receptor, CXCR5, was greatly elevated in vivo on BL tumor cells in this model, as shown by flow cytometry. CXCL13 is the ligand for CXCR5, and serum and ascites levels of murine, but not human, CXCL13 showed a striking elevation in tumor-bearing mice, with levels as high as 200,000 pg/ml in ascites, as measured by ELISA. As shown by immunohistochemistry, murine CXCL13 was associated with macrophage-like tumor-infiltrating cells that appeared to be histiocytes. Blocking CXCR5 on 2F7 cells with neutralizing antibodies prior to injection into the mice substantially delayed tumor formation. The marked elevations in tumor cell CXCR5 expression and in murine CXCL13 levels seen in the model may potentially identify an important link between tumor-interacting histiocytes and tumor cells in AIDS-BL. These results also identify CXCL13 as a potential biomarker for this disease, which is consistent with previous studies showing that serum levels of CXCL13 were elevated in human subjects who developed AIDS-lymphoma. This mouse model may be useful for future studies on the interactions of the innate immune system and AIDS-BL tumor cells, as well as for the assessment of potential tumor biomarkers for this disease.
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Affiliation(s)
- Daniel P. Widney
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA AIDS Institute, University of California Los Angeles, Los Angeles, California, United States of America
| | - Tove Olafsen
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- California NanoSystems Institute, University of California Los Angeles, Los Angeles, California, United States of America
| | - Anna M. Wu
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, United States of America
- California NanoSystems Institute, University of California Los Angeles, Los Angeles, California, United States of America
| | - Christina M. R. Kitchen
- Department of Biostatistics, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | - Jonathan W. Said
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA AIDS Institute, University of California Los Angeles, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, United States of America
| | - Jeffrey B. Smith
- Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, United States of America
| | - Guadalupe Peña
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA AIDS Institute, University of California Los Angeles, Los Angeles, California, United States of America
| | - Larry I. Magpantay
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA AIDS Institute, University of California Los Angeles, Los Angeles, California, United States of America
| | - Manuel L. Penichet
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, United States of America
- Department of Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, United States of America
| | - Otoniel Martinez-Maza
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, California, United States of America
- Department of Microbiology, Immunology and Molecular Genetics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, United States of America
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
- UCLA AIDS Institute, University of California Los Angeles, Los Angeles, California, United States of America
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California, United States of America
- * E-mail:
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15
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Stander S, Holmes H, Dreyer WP, Afrogheh A, Mohamed N, Hille J, Osman N. Oral medicine case book 49: Plasmablastic lymphoma. SADJ 2013; 68:184-186. [PMID: 23971300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- S Stander
- Division of Oral Medicine and Periodontics, University of the Western Cape
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16
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Tajima K, Kohno K, Shiono Y, Suzuki I, Kato Y, Hiroshima Y, Yamamoto M, Ohtake H, Iwaba A, Yamakawa M, Kato T. Acute kidney injury and inflammatory immune reconstitution syndrome in mixed genotype (A/E) hepatitis B virus co-infection in HIV-associated lymphoma. Int J Clin Exp Pathol 2013; 6:536-542. [PMID: 23411777 PMCID: PMC3563184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/29/2012] [Indexed: 06/01/2023]
Abstract
We report a first case of HIV-associated lymphoma (HAL) presenting with acute kidney injury (AKI) and inflammatory immune reconstitution syndrome (IRIS). A 39-year-old male, treated with nonsteroidal anti-inflammatory drugs (NSAIDs) for one month prior to admission, developed AKI, left testicular tumor, and recurrent swelling of the right parotid gland. A resected testicular tumor exhibited features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Renal biopsy showed hydro-degeneration of renal tubules, interstitial inflammatory cells, and a small number of lymphoma cells in the sub-capsule, compatible with acute interstitial nephritis. His renal dysfunction rapidly recovered following chemotherapy and combination antiretroviral therapy (cART). He developed pneumonia concomitantly with a decrease in HIV-RNA level and an increase in CD4+ cells after the first cycle of chemotherapy, which spontaneously resolved after the second cycle of chemotherapy without additional anti-infection drugs; thus, his pneumonia fulfilled the diagnostic criteria for IRIS. We suggest that IRIS may frequently develop during chemotherapy for HAL, but may be overlooked. He was coinfected with hepatitis B virus (HBV), which genotypes known as is associated with liver-related mortality and response to antiviral therapy; recently, an intimate interplay between HIV and HBV in the onset of lymphoma has been reported. Therefore, we addressed the HBV genotype in the patient. The analysis revealed that he exhibited a mixed genotype (A/E) not native to Japan and primarily found in Europe and North America or West Africa. These findings suggest that universal vaccination for juveniles against HBV is warranted in Japan.
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Affiliation(s)
- Katsushi Tajima
- Department of Radiation Emergency Medicine, National Institute of Radiological Sciences Chiba, Japan.
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17
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Zhao XF, Zhao MY, Chai L, Kukuruga D, Tan M, Stass SA. Amplified RPS6KB1 and CDC2 genes are potential biomarkers for aggressive HIV+/EBV+ diffuse large B-cell lymphomas. Int J Clin Exp Pathol 2013; 6:148-154. [PMID: 23330000 PMCID: PMC3544236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 11/27/2012] [Indexed: 06/01/2023]
Abstract
RPS6KB1 encodes p70S6K/p85S6K, which plays a role in the PI3K/Akt/mTOR signal transduction pathway. CDC2 gene encodes cdc2, which is critical for G2/M cell cycle progression. We had previously shown that amplified RPS6KB1 and CDC2 are commonly detected in the EBV+ diffuse large B-cell lymphoma (DLBCL) in HIV patients. In current study, we further evaluated the amplified RPS6KB1 and CDC2 genes in 12 HIV-related aggressive B-cell lymphomas and 10 non-HIV-related DLBCL using real time quantitative PCR. The cases were divided into 4 groups: 1) HIV-/EBV-; 2) HIV-/EBV+; 3) HIV+/EBV-; and 4) HIV+/EBV+. Receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to assess the ability of each gene to distinguish non-HIV+/EBV+ cases from HIV+/EBV+ cases. The AUC was estimated to be 0.76 for RPS6KB1 and 0.74 for CDC2 by using the Mann-Whitney statistic. Amplified RPS6KB1 and CDC2 genes were more frequently detected in common variants of DLBCL associated with HIV infection. Taken together, amplified RPS6KB1 and CDC2 are potential biomarkers for the aggressive DLBCL, particularly in HIV+/EBV+ patients. This study also suggests that the HIV+/EBV+ aggressive DLBCL could be potentially treated by targeting RPS6KB1 and CDC2 genes.
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MESH Headings
- Biomarkers, Tumor/genetics
- CDC2 Protein Kinase
- Cell Division/genetics
- Cyclin B/genetics
- Cyclin-Dependent Kinases
- Epstein-Barr Virus Infections/complications
- G2 Phase/genetics
- HIV Infections/complications
- Humans
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- ROC Curve
- Ribosomal Protein S6 Kinases, 70-kDa/genetics
- Signal Transduction/genetics
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Affiliation(s)
- Xianfeng F Zhao
- Department of Pathology, Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
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18
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Park J, Kim TM, Hwang JH, Kim NH, Choe PG, Song KH, Kim ES, Park SW, Kim HB, Kim NJ, Park WB, Oh MD. Risk factors for febrile neutropenia during chemotherapy for HIV-related lymphoma. J Korean Med Sci 2012; 27:1468-71. [PMID: 23255844 PMCID: PMC3524424 DOI: 10.3346/jkms.2012.27.12.1468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 09/20/2012] [Indexed: 11/20/2022] Open
Abstract
We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/µL with body temperature over 38℃; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.
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Affiliation(s)
- Jinyong Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong-Hwan Hwang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Nak-Hyun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Pyoeng Gyun Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung-ho Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Won Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Nam Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myoung-don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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19
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Chao C, Silverberg MJ, Martínez-Maza O, Chi M, Abrams DI, Haque R, Zha HD, McGuire M, Xu L, Said J. Epstein-Barr virus infection and expression of B-cell oncogenic markers in HIV-related diffuse large B-cell Lymphoma. Clin Cancer Res 2012; 18:4702-12. [PMID: 22711707 PMCID: PMC3846529 DOI: 10.1158/1078-0432.ccr-11-3169] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE Epstein-Barr virus (EBV)-mediated lymphomagenesis in the setting of HIV infection has been widely accepted. However, little is known about how EBV impacts prognosis. We investigated the hypothesis that EBV infection is associated with expression of specific B-cell oncogenic markers in HIV-related diffuse large B-cell lymphoma (DLBCL) and examined the prognostic use of detecting EBV infection. EXPERIMENTAL DESIGN HIV-related DLBCL cases diagnosed between 1996 and 2007 within Kaiser Permanente California were identified. Immunohistochemical staining was used to analyze the expression of selected markers that are cell-cycle regulators, B-cell activators, and antiapoptotic proteins among others. EBV infection was determined by in situ hybridization of EBV RNA. Correlations between EBV and marker expression were examined using Spearman correlation coefficient. The prognostic use of EBV status was examined in multivariable Cox model adjusting for International Prognostic Index (IPI). Receiver-operating characteristics (ROC) analysis was used to evaluate improvement in model discrimination. RESULTS Seventy HIV-related DLBCL cases were included (31% EBV±). EBV+ tumor was associated with increased expression of BLIMP1 and CD30 and reduced expression of BCL6 and LMO2. EBV+ tumor was independently associated with elevated 2-year overall mortality [HR, 3.3; 95% confidence interval (CI), 1.6-6.6]. Area under the ROC curve showed improved model discrimination when incorporating tumor EBV status with IPI in the prediction model [0.65 vs. 0.74 (IPI only)]. CONCLUSION Our results suggest that EBV infection was associated with expression of several tumor markers that are involved in the NF-κB pathway and that detecting tumor EBV status may have prognostic use in HIV-related DLBCLs.
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MESH Headings
- Acquired Immunodeficiency Syndrome/complications
- Acquired Immunodeficiency Syndrome/metabolism
- Acquired Immunodeficiency Syndrome/pathology
- Adaptor Proteins, Signal Transducing/metabolism
- Apoptosis
- B7-1 Antigen/metabolism
- Cell Cycle Proteins/metabolism
- DNA-Binding Proteins/metabolism
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/metabolism
- Epstein-Barr Virus Infections/pathology
- Follow-Up Studies
- Gene Expression Regulation, Neoplastic
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 4, Human/pathogenicity
- Humans
- In Situ Hybridization
- Kaplan-Meier Estimate
- Ki-1 Antigen/metabolism
- LIM Domain Proteins/metabolism
- Lymphoma, AIDS-Related/complications
- Lymphoma, AIDS-Related/metabolism
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/virology
- NF-kappa B/metabolism
- Positive Regulatory Domain I-Binding Factor 1
- Prognosis
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-bcl-6
- Repressor Proteins/metabolism
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Affiliation(s)
- Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, 2nd Floor, Los Angeles, CA 91101, USA.
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20
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21
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Rizwan MM, Gaba P. Extranodal non-Hodgkin's lymphoma in HIV. J PAK MED ASSOC 2012; 62:733-734. [PMID: 23866528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Lymphoma in acquired immunodeficiency syndrome (AIDS) is associated with frequent involvement of extra-nodal sites, rapid clinical progression and aggressive histology. We present a case of extra nodal non-Hodgkin's lymphoma (NHL) with probable multifocal involvement.
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22
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Riancho J, Gutiérrez-Vela C, Sánchez R, Valero C. Anaplastic large cell lymphoma as a cause of rapidly appearing subcutaneous nodules in an HIV-infected patient. Enferm Infecc Microbiol Clin 2012; 30:581-2. [PMID: 22633762 DOI: 10.1016/j.eimc.2012.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/19/2012] [Accepted: 04/04/2012] [Indexed: 12/01/2022]
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23
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Ibrahim HAH, Menasce L, Pomplun S, Burke M, Bower M, Naresh KN. Tumour infiltrating plasmacytoid dendritic cells in B cell post-transplant lymphoproliferative disorders, human immunodeficiency virus-associated B cell lymphomas and immune competent diffuse large B cell lymphomas. Histopathology 2011; 59:152-6. [PMID: 21771035 DOI: 10.1111/j.1365-2559.2011.03872.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Child
- Child, Preschool
- Dendritic Cells/immunology
- Dendritic Cells/pathology
- Female
- Humans
- Immunocompetence
- Immunohistochemistry
- Interleukin-3 Receptor alpha Subunit/metabolism
- Lectins, C-Type/metabolism
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoproliferative Disorders/etiology
- Lymphoproliferative Disorders/immunology
- Lymphoproliferative Disorders/pathology
- Male
- Membrane Glycoproteins/metabolism
- Middle Aged
- Receptors, Immunologic/metabolism
- Transplants/adverse effects
- Young Adult
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24
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Avilés-Salas A, Cornejo-Juárez P, Sobrevilla-Calvo PDJ. [Coexistence of plasmablastic lymphoma, Kaposi sarcoma and Castleman disease in a patient with HIV infection]. Rev Chilena Infectol 2011; 28:76-80. [PMID: 21526292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Plasmablastic lymphoma (PL) is an uncommon B-cell lymphoma that is strongly associated with human immunodeficiency virus (HIV) infection, and displays distinctive affinity for extranodal presentation in the oral cavity. We report the case of a PL involving the stomach in a 36 year-old man HIV+ patient, associated with Kaposi sarcoma (KS) in sections adjacent to lymphoma. He had a positive history of Castleman disease and KS in a lymphoid node biopsy.
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25
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Schalper KA, Valbuena JR. [Primary cerebral lymphomatoid granulomatosis in a HIV-positive patient. Case report]. Rev Med Chil 2011; 139:218-223. [PMID: 21773660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report a 34-years-old male, with a history of hepatitis B and human immunodeficiency virus (HIV) infection that was admitted to the hospital with malaise, weight loss, frontal behavior and chest pain. Imaging studies showed two frontal cortical/subcortical nodules. A stereotactic cerebral biopsy showed reactive gliosis and a prominent atypical angiocentric and angiodestructive lymphoid infiltrate containing large pleomorphic CD20 and EBV-positive cells consistent with Lymphomatoid granulomatosis. Other studies were negative. The patient was lost from follow up.
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Affiliation(s)
- Kurt A Schalper
- Departamento de Anatomía Patológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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26
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Avilés-Salas A, Herrera-Goepfert R, Aguilar-León D, Candelaria-Hernández M, Martínez-Cordero E, Corti M. [Plasmablastic lymphoma of the gastrointestinal tract in AIDS patients]. Medicina (B Aires) 2011; 71:536-541. [PMID: 22167727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The risk of developing non-Hodgkin lymphoma (NHL) is 200 times higher in HIV-positive patients than otherwise healthy persons. Plasmablastic lymphoma (PL) represents < 3% of all NHL associated with HIV infection. The aim of this study was to review the clinical-pathologic features of PL of the gastrointestinal tract in 5 patients with HIV/aids disease. We performed a retrospective study of PL of the gastrointestinal tract diagnosed at the National Institute of Cancer at Mexico City, from 2000 to 2009. Clinical and pathological information was obtained and immunohistochemical studies were performed in paraffin-embedded tissue sections. The presence of Epstein-Barr Virus (EBV) was examined by in situ polymerase chain reaction (PCR). Four male and 1 female were included with a median of age of 29 years. Three tumors involved the ano-rectal area, one tumor the ascendant colon and one tumor the stomach. All tumors were histologically characterized by a monotonous proliferation of large lymphoid cell with plasmablastic features. Tumor cells were CD 138 / MUM-1 positive and CD 20 / PAX-5 negative in all cases. EVB genome was detected by in situ PCR in 4 cases. The median of follow-up was 18 months, and revealed that three patients are alive with neoplasm disease and two patients are still alive with no evidence of the neoplasm. Recognition of this entity by pathologists and clinicians is important in order to establish the correct diagnosis and the early treatment of these patients.
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27
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Castillo JJ, Winer ES, Stachurski D, Perez K, Jabbour M, Milani C, Colvin G, Butera JN. Prognostic factors in chemotherapy-treated patients with HIV-associated Plasmablastic lymphoma. Oncologist 2010; 15:293-9. [PMID: 20167839 DOI: 10.1634/theoncologist.2009-0304] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Plasmablastic lymphoma (PBL) is a variant of diffuse large B-cell lymphoma commonly seen in the oral cavity of HIV-infected individuals. PBL has a poor prognosis, but prognostic factors in patients who have received chemotherapy have not been adequately evaluated. METHODS An extensive literature search rendered 248 cases of PBL, from which 157 were HIV(+). Seventy cases with HIV-associated PBL that received chemotherapy were identified. Whenever possible, authors of the original reports were contacted to complete clinicopathological data. Univariate analyses were performed calculating Kaplan-Meier estimates and compared using the log-rank test. RESULTS The mean age was 39 years, with a male predominance. The mean CD4(+) count was 165 cells/mm(3). Advanced clinical stage was seen in 51% and extraoral involvement was seen in 43% of the cases. The expression levels of CD20 and Epstein-Barr virus-encoded RNA were 13% and 86%, respectively. The overall survival duration was 14 months. In a univariate analysis, early clinical stage and a complete response to chemotherapy were associated with longer survival. There was no apparent difference in survival with regimens more intensive than cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). CONCLUSIONS Patients with HIV-associated PBL have a poor prognosis. Prognosis is strongly associated with achieving a complete clinical response to CHOP or CHOP-like chemotherapy. The role of more intensive regimens is currently unclear. Further research is needed to improve responses using novel therapeutic agents and strategies.
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Affiliation(s)
- Jorge J Castillo
- 164 Summit Avenue, Fain Building, Providence, Rhode Island 02906, USA.
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28
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Armstrong EJ, Bhave P, Wong D, Ursell PC, Kaplan L, Yeghiazarians Y, Ai WZ. Left ventricular rupture due to HIV-associated T-cell lymphoma. Tex Heart Inst J 2010; 37:457-460. [PMID: 20844622 PMCID: PMC2929872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Patients with lymphoma can develop cardiac involvement that includes malignant pericardial effusions and myocardial infiltration, but extensive myocardial invasion by tumor with resultant rupture has been reported only rarely. We report a case of a patient with human immunodeficiency virus and T-cell lymphoma who presented with signs and symptoms that were suggestive of a non-ST-elevation myocardial infarction. Plans were made for cardiac catheterization, but the patient developed thrombocytopenia after the initiation of heparin and eptifibatide. Cardiac catheterization was deferred, and shortly afterwards he had a witnessed cardiac arrest in the hospital and could not be resuscitated. Autopsy revealed transmural infiltration of the myocardium with lymphoma and resultant rupture of the left ventricular free wall. To our knowledge, this is the 1st reported case of left ventricular free-wall rupture due to transmural infiltration by human-immunodeficiency-virus-associated peripheral T-cell lymphoma.We conclude that noncoronary causes of chest pain, including direct myocardial infiltration, should be considered in immunocompromised patients with lymphoma.
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Affiliation(s)
- Ehrin J Armstrong
- Division of Cardiology, University of California, San Francisco 94143, California, USA.
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29
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Corti M, de Dios Soler M, Bare P, Villafañe MF, De Tezanos Pinto M, Perez Bianco R, Narbaitz M. [AIDS related lymphomas: Histopathological subtypes and association with Epstein Barr virus and Human Herpes virus type-8]. Medicina (B Aires) 2010; 70:151-158. [PMID: 20447898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Non-Hodgkin lymphomas (NHL) of the B-cell type are the second most common neoplasm among patients with human immunodeficiency virus (HIV) infection and AIDS. Here, we evaluated 48 cases of AIDS-related lymphomas (ARL) diagnosed at the Histopathological Division of the Instituto de Investigaciones Hematológicas of the National Academy of Medicine. Five were females and 43 were males with a median of age of 37 years at the time of the diagnosis. Micrometer sections were prepared and stained with hematoxilin-eosin; immunohistochemical examination for the presence of Epstein-Barr virus (EBV) was carried out in 48/48 cases. Additionally, biotinilated oligonucleotides were used to determine the presence of DNA of the Human Herpes virus type-8 (HHV-8) in 14/14 biopsy smears corresponding to plasmablastic lymphomas (PL). All were fenotype B cell lymphomas with an aggressive course and advanced neoplasm disease at the time of diagnosis. Virological findings showed the strong association between EBV and AIDS-related NHL. According to the histopathological subtype, the EBV genome was detected in 16/21 (76%) diffuse large B cell lymphomas, 1/3 Burkitt lymphoma and 3/4 (75%) of primary central nervous system lymphomas. Globally, EBV genome was detected in 20/28 NHL of this series. Detection of HHV-8 was negative in all cases of PL. Hodgkin lymphoma were more frequent in males 18/20 (90%), with an aggressive clinical course and a significant predominance of the subtypes associated with worse prognosis (90% of cases). We detected a significant association between EBV and HL (90% of cases). We consider that all cases of AIDS related lymphomas should be assessed for the presence of EBV because its presence may play a role in the prognosis.
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Affiliation(s)
- Marcelo Corti
- Hospital de Enfermedades Infecciosas F. J. Muniz, Buenos Aires.
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30
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Verma N, Chaudhary UB, Costa LJ, Gudena V, Lazarchick J. Primary testicular lymphoma and AIDS. Ann Clin Lab Sci 2010; 40:75-79. [PMID: 20124334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Immunosuppressed patients have an increased risk for developing extranodal lymphoma, including testicular lymphoma. In AIDS patients, primary testicular lymphoma has been reported as an initial manifestation of the disease. These patients typically present at an early age; their lymphomas usually have aggressive histologic appearance and are associated with poor prognosis. We report a testicular lymphoma consistent with diffuse large B-cell lymphoma (DLBCL) in an AIDS patient and we review the literature on primary testicular lymphoma in AIDS patients.
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Affiliation(s)
- Nitin Verma
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
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31
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Corti M, Carolis LD, Solari R, Villafañe MF, Schtirbu R, Lewi D, Narbaitz M. Non Hodgkin's lymphoma with cutaneous involvement in AIDS patients: report of five cases and review of the literature. Braz J Infect Dis 2010; 14:81-85. [PMID: 20428660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Accepted: 10/10/2009] [Indexed: 05/29/2023] Open
Abstract
Cutaneous B cell lymphoma (CBCL) is a lymphoproliferative disorder of neoplastic B cell of the skin with a wide range of clinical manifestations. Commonly, the clinical features of CBCL are plaques, nodules, or ulcerative lesions. Skin is one of the common sites for extra-nodal lymphomas in patients with AIDS and B cell type is less common than T cell type. Only recently, the existence of B cell lymphomas presenting clinically in the skin without evidence of extra-cutaneous involvement has been accepted as primary CBCL. Here, we are presenting 5 patients with cutaneous involvement in the setting of HIV/AIDS disease. Two of them were primary cutaneous non-Hodgkin lymphomas. All were CBCL; 3 were immunoblastic, 1 was plasmablastic, and the other was a Burkitt lymphoma. We analyzed the epidemiological, clinical, virological, and immunological characteristics of this group of patients.
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Affiliation(s)
- Marcelo Corti
- Division of HIV/AIDS disease, Puán 381, 2 piso, C1406CQG Buenos Aires, Argentina.
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32
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Pantanowitz L, Pihan G, Carbone A, Dezube BJ. Differentiating HIV-associated non-Hodgkin's lymphomas with similar plasmacellular differentiation. J HIV Ther 2009; 14:24-33. [PMID: 19839364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
MESH Headings
- Burkitt Lymphoma/pathology
- Cell Differentiation
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 8, Human/isolation & purification
- Humans
- Lymphoma, AIDS-Related/etiology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Non-Hodgkin/etiology
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/virology
- Lymphoproliferative Disorders/pathology
- Plasma Cells/pathology
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Baystate Medical Center, Tufts School of Medicine, Springfield 01199, USA.
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33
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Castillo J, Perez K, Milani C, Dezube BJ, Pantanowitz L. Peripheral T-cell lymphomas in HIV-infected individuals: a comprehensive review. J HIV Ther 2009; 14:34-40. [PMID: 19839365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Lymphoma, AIDS-Related/mortality
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/therapy
- Lymphoma, AIDS-Related/virology
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Lymphoma, T-Cell, Peripheral/therapy
- Lymphoma, T-Cell, Peripheral/virology
- Male
- Middle Aged
- Prognosis
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Affiliation(s)
- Jorge Castillo
- Division of Hematology/Oncology, The Miriam Hospital, Brown University Warren Alpert Medical School, Providence, RI 02906, USA.
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Bedoya F, Medveczky MM, Lund TC, Perl A, Horvath J, Jett SD, Medveczky PG. Identification of mitochondrial genome concatemers in AIDS-associated lymphomas and lymphoid cell lines. Leuk Res 2009; 33:1499-504. [PMID: 19362738 DOI: 10.1016/j.leukres.2009.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Revised: 03/11/2009] [Accepted: 03/12/2009] [Indexed: 12/24/2022]
Abstract
Since most oncogenic viruses persist as extrachromosomal covalently closed circular DNA (cccDNA) in tumor cells, we developed an assay to visualize and identify cccDNA in primary lymphomas. We identified concatemers of the mitochondrial genome in all samples analyzed, but not in normal lymphocytes. One AIDS-associated lymphoma (EL) was further studied in detail as its mitochondrial genome consisted of tandem head-to-tail duplications. Insertion of C-residues was noted near the origin of replication of EL mtDNA. EL cells responded weakly to Fas-apoptotic stimulus, displayed reduced mitochondrial activity and mass, and produced higher levels of reactive oxygen intermediates. Screening of several AIDS-associated lymphomas and established lymphoid cell lines also revealed the presence of mitochondrial genome concatemers consisting of interlinked monomer molecules. Taken together, our results suggest that formation of mtDNA concatemers is associated with oncogenic transformation in lymphoid cells.
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Affiliation(s)
- Felipe Bedoya
- Department of Molecular Medicine, College of Medicine, University of South Florida, Tampa, FL 33612, United States
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35
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Kaaya EE, Castaños-Velez E, Ekman M, Mwakigonja A, Carneiro P, Lema L, Kitinya J, Linde A, Biberfeld P. AIDS and non AIDS-related malignant lymphoma in Tanzania. Afr Health Sci 2009; 6:69-75. [PMID: 16916294 PMCID: PMC1831982 DOI: 10.5555/afhs.2006.6.2.69] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Malignant lymphoma (ML) in HIV patients, are second in frequency to Kaposi's sarcoma (AKS) as AIDS-defining tumors. In Africa the frequency of AIDS-related lymphoma (ARL) is rare and the findings are controversial. Kaposi's sarcoma (KS) lesions are now causally associated with KSHV/HHV-8 but whether African ARL shows this association is not clear. METHOD Cancer registry data was reviewed for retrospective cases. Both retrospective and prospective lymphoma cases were classified according to the revised European-American (REAL) classification. Immunephenotyping was performed on both frozen and fixed paraffin sections. Viral DNA was assessed by polymerase chain reaction (PCR) of formalin fixed or frozen biopsies. In situ hybridization (ISH) was used to determine the presence of EBV encoded RNA (EBER). OBJECTIVES To determine the frequency and type of AIDS and non-AIDS related malignant lymphoma in Tanzania and a possible co-association with KSHV/HHV-8 and EBV. RESULTS An overall increasing tendency for ML in Tanzania was observed during 1991-94 and a clear increase from 1993. The tumors were classified as Burkitt's (6), diffuse large cell (10), precursor-B lymphoblastic (1) and Hodgkin's disease (5) from HIV positive and negative patients. Ten (40%) high grade ML and three Hodgkin's lymphoma from HIV patients had HHV-8 DNA. These findings were not related to age, sex or type of lymphoma. There was no association of HHV-8 with the lymphoma cells. Epstein-Barr virus (EBV) was demonstrable in most (13/18; 72%) of the tested tumors and seven (31.8%) had both HHV-8 and EBV. CONCLUSIONS This study suggests an overall increased frequency of ML patients infected with HHV-8 in Tanzania particularly in HIV patients which may result from the well established high HHV-8 prevalence in the general population, but HHV-8 was not associated with ARL pathogenesis as reflected by lack of tumor cell infection. As opposed to EBV, measures targeting HHV-8 for control of ML may therefore not be appropriate.
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MESH Headings
- Adolescent
- Adult
- Aged
- Biopsy, Needle
- Burkitt Lymphoma/epidemiology
- Burkitt Lymphoma/pathology
- Child
- Child, Preschool
- Developing Countries
- Female
- Herpesvirus 4, Human/isolation & purification
- Herpesvirus 8, Human/isolation & purification
- Hodgkin Disease/epidemiology
- Hodgkin Disease/pathology
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Incidence
- Lymphoma/epidemiology
- Lymphoma/pathology
- Lymphoma, AIDS-Related/epidemiology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Non-Hodgkin/epidemiology
- Lymphoma, Non-Hodgkin/pathology
- Male
- Middle Aged
- Polymerase Chain Reaction
- Registries
- Retrospective Studies
- Risk Assessment
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Survival Analysis
- Tanzania/epidemiology
- Young Adult
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Affiliation(s)
- Ephata E Kaaya
- Immunopathology Laboratory, Karolinska Institute, Stockholm, Sweden.
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36
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Pantanowitz L, Castillo J, Freeman JK, Dezube BJ. Images in HIV/AIDS. Fatal HIV-associated anaplastic large-cell lymphoma. AIDS Read 2009; 19:19-21. [PMID: 19209452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA
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37
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Yotsumoto M, Ichikawa N, Ueno M, Higuchi Y, Asano N, Kobayashi H. CD20-negative CD138-positive leukemic large cell lymphoma with plasmablastic differentiation with an IgH/MYC translocation in an HIV-positive patient. Intern Med 2009; 48:559-62. [PMID: 19336959 DOI: 10.2169/internalmedicine.48.1359] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 49-year-old HIV-positive Japanese man was referred to our hospital for multiple skin nodules. Many plasmablastic atypical lymphocytes were observed in the peripheral blood. He was diagnosed with diffuse large B cell lymphoma (DLBCL) by a biopsy of the inguinal lymph node. IgH/MYC translocation was detected by in situ hybridization of the lymph node and chromosomal analysis of bone marrow cells showed 46, XY, t(8 ; 14)(q24 ; q32)add(14)(q32), der(21)t(1 ; 21)(q12 ; p11). He showed a transient response to multi-agent chemotherapy, and during the course of salvage chemotherapy, he died of urinary infection. This case has unique clinical features compared with previously reported DLBCLs with plasmablastic differentiation.
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MESH Headings
- Antigens, Neoplasm/analysis
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biopsy
- Cytomegalovirus Retinitis/complications
- Cytomegalovirus Retinitis/drug therapy
- Dexamethasone/administration & dosage
- Doxorubicin/administration & dosage
- Epstein-Barr Virus Infections/diagnosis
- Fatal Outcome
- Ganciclovir/therapeutic use
- Genes, myc
- Humans
- Immunoglobulin Heavy Chains/genetics
- Lymph Nodes/pathology
- Lymphoma, AIDS-Related/chemistry
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/pathology
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/chemistry
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Male
- Middle Aged
- Salvage Therapy
- Skin Neoplasms/diagnosis
- Skin Neoplasms/pathology
- Syndecan-1/analysis
- Translocation, Genetic
- Urinary Tract Infections/complications
- Vincristine/administration & dosage
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38
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Abstract
Introduction Orbital cellulitis is an uncommon, potentially devastating condition that, when not promptly and adequately treated, can lead to serious sequelae. The presenting clinical signs are proptosis, swelling, ophthalmoplegia, pain and redness of the peri-orbital tissues. A number of cases have been reported in which these symptoms have been mistakenly interpreted as being secondary to an orbital infection whilst, in fact, other pathology was present. Discussion We add another case in which, on clinical grounds and after radiological assessment and laboratory tests, a working diagnosis of orbital cellulitis of the left eye was made. It was only after histopathological analysis of a soft tissue specimen from the maxillary sinus that a diagnosis of an AIDS-related plasmablastic lymphoma was made. The patient was referred to the department of haematology where chemotherapeutic treatment for the lymphoma and the HIV infection was started. This case report adds another differential diagnosis of orbital cellulitis to the existing literature.
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Affiliation(s)
- Richard Barkhuysen
- Department of Oral and Maxillofacial Surgery 590, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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39
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Zaragoza V, Martínez L, Pérez-Ferriols A, Alegre V. [Cutaneous presentation of plasmablastic lymphoma in a patient with HIV Infection]. Actas Dermosifiliogr 2008; 99:820-821. [PMID: 19091226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
MESH Headings
- Adult
- Antigens, CD/analysis
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Fatal Outcome
- Female
- Hepatitis B, Chronic/complications
- Hepatitis C, Chronic/complications
- Humans
- Infusions, Intravenous
- Injections, Spinal
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- Substance Abuse, Intravenous/complications
- Vincristine/administration & dosage
- Vincristine/adverse effects
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40
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Gotoh M, Kitahara T, Iguchi T, Izumi M, Mukai K, Ohyashiki K. [HIV-related multiple non-Hodgkin lymphomas]. Rinsho Ketsueki 2008; 49:1552-1555. [PMID: 19047787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 35-year-old man was admitted with continuous general fatigue and low grade fever. He was HIV-positive, and had gastric diffuse large B-cell lymphoma and renal T-cell anaplastic large cell lymphoma (T-ALCL). We diagnosed double lymphomas related to AIDS. The patient received anti-retroviral therapy, and started the CHOP regimen for the double lymphomas, resulting in transient improvement. However, fever again appeared during HAART and CHOP treatment, and a right inguinal subcutaneous lesion appeared. Biopsy specimen demonstrated null cell ALCL, and this patient demonstrated multiple lymphomas. This case suggested that cancer generation was promoted by low immunity, although it is known that ambivalent tumors such as non-Hodgkin lymphomas can occur frequently.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Humans
- Kidney Neoplasms/diagnosis
- Kidney Neoplasms/drug therapy
- Lymphocytes, Null
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/pathology
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/drug therapy
- Male
- Neoplasms, Multiple Primary
- Prednisolone/administration & dosage
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Vincristine/administration & dosage
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Affiliation(s)
- Moritaka Gotoh
- First Department of Internal Medicine, Tokyo Medical University
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41
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Moreira E, Lisboa C, Alves S, Moreira II, Fonseca E, Azevedo F. Cutaneous lesions as the first manifestation of systemic follicular lymphoma in an HIV patient. Dermatol Online J 2008; 14:17. [PMID: 18718201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Human immunodeficiency virus (HIV) patients have an increased incidence of lymphomas, particularly when there is a significant immunosuppression. Most commonly, they are non-Hodgkin B cell type with a high or intermediate grade and have an extranodal presentation. We report the case of a 38-year-old man with HIV infection who presented with a 1-year history of a painless tumor on the back and lymphadenopathies. The diagnosis of B cell lymphoma follicle center cell type was established by skin biopsy. Staging included a bone marrow biopsy revealing infiltration by the lymphoma and a whole-body computed tomographic scan showing multiple cervical and axillary lymphadenopathies with necrotic center. Biopsy of an axillary lymph node revealed caseating epithelioid granulomas and Ziehl-Neelson staining was positive for acid-fast bacilli. The patient started therapy for tuberculosis and polychemotherapy for lymphoma with complete response. This report illustrates a case of simultaneous occurrence of tuberculosis and systemic follicular lymphoma presenting in skin in an HIV patient.
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MESH Headings
- Adult
- Antineoplastic Agents/therapeutic use
- Biopsy, Needle
- Diagnosis, Differential
- Follow-Up Studies
- Humans
- Immunohistochemistry
- Lymphatic Diseases/pathology
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/pathology
- Male
- Risk Assessment
- Severity of Illness Index
- Tomography, X-Ray Computed
- Treatment Outcome
- Tuberculosis, Cutaneous/diagnosis
- Tuberculosis, Cutaneous/drug therapy
- Tuberculosis, Cutaneous/pathology
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42
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Baik SJ, Shim KN, Choi HJ, Jung SA, Yoo K. [Small bowel lymphoma detected by MiroCam capsule endoscope in a patient with acquired immune deficiency syndrome]. Korean J Gastroenterol 2008; 52:37-41. [PMID: 19077490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Human immunodeficiency virus (HIV) infection is a risk factor for developing non-Hodgkin's lymphoma. Most acquired immune deficiency syndrome (AIDS)-related lymphomas are high-grade B cell non-Hodgkin's lymphomas. The use of highly active antiretroviral therapy has reduced the incidence of AIDS-related lymphoma. There have been 7 reports of AIDS-related extra-nodal lymphoma in Korea. We report a case of AIDS-related lymphoma detected by MiroCam capsule endoscopy.
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Affiliation(s)
- Su Jung Baik
- Department of Internal Medicine, Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea
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43
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Riedel DJ, Gonzalez-Cuyar LF, Zhao XF, Redfield RR, Gilliam BL. Plasmablastic lymphoma of the oral cavity: a rapidly progressive lymphoma associated with HIV infection. Lancet Infect Dis 2008; 8:261-7. [PMID: 18353267 DOI: 10.1016/s1473-3099(08)70067-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Plasmablastic lymphoma of the oral cavity is a form of non-Hodgkin lymphoma (NHL) and was first described in 1997. We describe a case of plasmablastic lymphoma in an HIV-infected patient who presented with an expanding oral lesion and symptoms of a toothache. We review all cases of plasmablastic lymphoma that have been reported in the literature. Plasmablastic lymphoma is strongly associated with immunodeficiency, and most particularly, with HIV infection. The pathophysiological origin of plasmablastic lymphoma has not been fully characterised, but the presence of Epstein-Barr virus (EBV) has often been documented in biopsy specimens, supporting a role for EBV in the pathogenesis of this lymphoma. The differential diagnosis for an expanding oral lesion includes both infectious and malignant processes. Biopsy is essential for making a correct and prompt diagnosis. Treatment usually involves chemotherapy, but antiretroviral therapy may also have an important role. Infectious disease clinicians should be aware of this newly described and increasingly encountered lymphoma, since it is prominently associated with immunosuppression and may be mistaken for other entities.
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Affiliation(s)
- David J Riedel
- Division of Infectious Diseases and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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44
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Crosswell HE, Bergsagel DJ, Yost R, Lew G. Successful treatment with modified CHOP-rituximab in pediatric AIDS-related advanced stage Burkitt lymphoma. Pediatr Blood Cancer 2008; 50:883-5. [PMID: 17278123 DOI: 10.1002/pbc.21161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Burkitt lymphoma is the most common AIDS-related lymphoma (ARL) in childhood. The major issues in adult and pediatric ARL include identifying the optimal chemotherapy regimen and the concurrent treatment of both rituximab and highly active anti-retroviral therapy (HAART). We present a case of advanced stage Burkitt lymphoma in an 8-year-old female with acquired immunodeficiency syndrome (AIDS), who was successfully treated with a 3 month course of modified CHOP-R (cyclophosphamide, daunorubicin, vincristine, prednisone, and rituximab) and HAART therapy. The combination of rituximab and chemotherapy with HAART therapy may be well-tolerated and effective in HIV/AIDS patients with Burkitt lymphoma.
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Affiliation(s)
- Howland E Crosswell
- Division of Pediatric Hematology/Oncology, Children's Hospital of the Greenville Hospital System, Greenville, South Carolina, USA.
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45
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Berk DR, Cheng A, Lind AC, Bayliss SJ. Burkitt lymphoma with cutaneous involvement. Dermatol Online J 2008; 14:14. [PMID: 18700117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- David R Berk
- Department of Internal Medicine and Pediatrics, Division of Dermatology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, MO.
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46
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Ribera JM, Oriol A, Morgades M, González-Barca E, Miralles P, López-Guillermo A, Gardella S, López A, Abella E, García M. Safety and efficacy of cyclophosphamide, adriamycin, vincristine, prednisone and rituximab in patients with human immunodeficiency virus-associated diffuse large B-cell lymphoma: results of a phase II trial. Br J Haematol 2008; 140:411-9. [PMID: 18162120 DOI: 10.1111/j.1365-2141.2007.06943.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Female
- Humans
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/immunology
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Prognosis
- Rituximab
- Survival Analysis
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Viral Load
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Affiliation(s)
- Josep-Maria Ribera
- Haematology Department, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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47
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Lather N, Islam M, Fergus IV. Symptomatic metastatic right atrial lymphoma in a patient with AIDS presenting with pulmonary embolization. Rev Cardiovasc Med 2008; 9:275-279. [PMID: 19122586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Tumors involving the heart are rare, and the majority of them are benign. Secondary lymphoma with localization to the heart is the third most common malignant heart tumor and is more common, by far, than primary cardiac lymphomas. In patients with human immunodeficiency virus, the risk of development of systemic lymphoma is 60 to 200 times higher than in the general population. Symptoms usually consist of chest pain and dyspnea. Patients can also present with obstructive symptoms, based on the location and size of the tumor, and signs such as elevated jugular venous pressure, peripheral edema, ascites, and hepatomegaly. Transthoracic echocardiography is the initial modality of choice for diagnosis of cardiac lymphomas because it is readily available and helps localize the tumor, but transesophageal echocardiography and magnetic resonance imaging remain the best tests for evaluation. Treatment consists primarily of chemotherapy, and anticoagulation can be used in certain cases where embolization of the tumor is likely. This case review describes a 37-year-old man with past medical history significant for herpes zoster and stage 1 syphilis who presented with complaints of weight loss, intermittent fevers, and vague chest pains of 1-month duration.
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Affiliation(s)
- Navneet Lather
- Department of Medicine, Columbia University, Harlem Hospital Center, New York, NY, USA
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48
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Keszler A, Piloni MJ, Paparella ML, Soler MDD, Ron PC, Narbaitz M. Extranodal oral non-Hodgkin's lymphomas. A retrospective study of 40 cases in Argentina. Acta Odontol Latinoam 2008; 21:43-48. [PMID: 18841745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A retrospective study was conducted of extranodal oral Non-Hodgkin's Lymphomas diagnosed at the Surgical Pathology Laboratory of the School of Dentistry at Buenos Aires University, Argentina, between 1985 and 2004. The 40 cases found represent 0.2% of the oral biopsies diagnosed during that time and 4.6% of malignant neoplasias. Overall mean age of patients was 49.4 years, and frequency was greater in males. 80% affected soft tissues. Prevalent location was gingival, followed by palate. Intraosseous cases were more frequent in mandible (75%) than in upper maxilla. 100% of the cases were phenotype B, with a higher frequency of high-grade aggressiveness. The most common histological type was Diffuse Large Cell Lymphoma. 60% of the Plasmablastic Lymphomas in the series came from HIV+ patients. Evolution time prior to consultation was 1 to 3 months in 57.7% of the cases.
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Affiliation(s)
- Alicia Keszler
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina.
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49
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Abstract
Plasmablastic lymphoma (PBL) is a rare entity most commonly identified in the oral cavity of immunodeficient patients. The immunophenotype of this condition shows a poor expression for B-cell markers but, in contrast, a strong reactivity for well-differentiated plasma cells markers, such as CD138, CD38, and epithelial membrane antigens. PBL survival is limited due to its highly aggressive local and metastatic behavior and poor response to treatment. Although it can involve different organs, there have been only a few cases involving the ocular adnexa. We describe a case of atypical rapidly progressive pre-septal brawny induration affecting the right orbit in a patient with HIV-related lymphoma.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Antiretroviral Therapy, Highly Active/methods
- Biopsy, Needle
- Disease Progression
- Fatal Outcome
- Female
- Humans
- Immunohistochemistry
- Lymphoma, AIDS-Related/diagnosis
- Lymphoma, AIDS-Related/drug therapy
- Lymphoma, AIDS-Related/pathology
- Lymphoma, Large-Cell, Immunoblastic/diagnosis
- Lymphoma, Large-Cell, Immunoblastic/drug therapy
- Lymphoma, Large-Cell, Immunoblastic/pathology
- Magnetic Resonance Imaging
- Orbital Neoplasms/diagnosis
- Orbital Neoplasms/drug therapy
- Orbital Neoplasms/pathology
- Risk Assessment
- Tomography, X-Ray Computed
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Affiliation(s)
- Alejandra A Valenzuela
- Department of Ophthalmology, Eyelid, Lacrimal, and Orbital Clinic, Royal Brisbane and Women's Hospital and the University of Queensland Medical School, Brisbane, Australia
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Horváth E, Krenács L, Bagdi E, Pávai Z, Macarie I, Nagy EE, Demian S. Plasmoblastic lymphoma associated with human immunodeficiency virus. Rom J Morphol Embryol 2008; 49:309-314. [PMID: 18758634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Plasmoblastic lymphoma (PBL) is a subtype of the diffuse large B-cell lymphoma, typically present as extranodal disease associated with human immune deficiency virus (HIV) infection. PBLs are often the initial manifestation of AIDS. Here we present a case of PBL concerning the oral cavity. A 34-year-old woman presented a tumor in the oral cavity that involved the maxilla and gingiva (confirmed by CT-scan). The gingival biopsy showed a massive infiltration by large lymphoid cells with round, vesicular nuclei, prominent nucleoli, fine chromatin and an significant amount of basophilic cytoplasm which express CD79a, CD138, cytoplasmic lambda light chain and LCA, without staining for CD20, CD38, CD3 and CTK. Serological analysis confirmed HIV positivity. PBLs lack most B-lineage markers, but many express CD79a in at least some of the cells, therefore generate difficulties in differential diagnosis. Overall assessment and correlation of the histopathological and immunohistochemical features with the clinical findings and serology investigation are the most helpful diagnostic tools and can lead to the final diagnosis.
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Affiliation(s)
- Emoke Horváth
- Department of Pathology, University of Medicine and Pharmacy of Targu Mures, Romania.
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