Human immunodeficiency virus‐associated malignant lymphoma in eastern Denmark diagnosed from 1990 to 1996: clinical features, histopathology, and association with Epstein‐Barr virus and human herpesvirus‐8

Abstract

The clinicopathological features of human immunodeficiency virus (HIV)-associated lymphoma were investigated in a retrospective study of 85 adult patients in eastern Denmark diagnosed during the period 1990-1996. The possible pathogenetic role of Epstein-Barr virus (EBV) and human herpesvirus 8 (HHV-8) in these tumours was also studied. Seventy patients (82%) presented with extranodal disease and 26 (31%) had CNS involvement at diagnosis. Diffuse large cell B-cell lymphoma was the most frequent histological subtype, comprising 65 of 79 cases available for microscopic re-evaluation (82%) and including 20 of 23 evaluable patients with CNS lymphoma (87%). EBV RNA was demonstrated by in situ hybridization in 51 of 65 evaluable tumours (79%) and in 14 of 16 cases (88%) with CNS-lymphoma. Three cases showed a T-cell phenotype. The presence of HHV-8 DNA was analysed by PCR in 32 cases. A strong band consistent with tumour cell infection was detected in only one case, weaker bands being seen in 4 cases. None of these patients had primary effusion lymphomas. In conclusion, Danish AIDS-related lymphomas are of predominantly high-grade B-cell type with extranodal localization and atypical presentation. Our results provide further evidence that EBV plays a major role in the pathogenesis of large cell AIDS-related lymphoma, whereas HHV-8 does not appear to contribute significantly to the development of solid lymphomas in this group of patients.

Immunoblastic Lymphoma in Persons with AIDS-Associated Kaposi’s Sarcoma: a Role for Kaposi’s Sarcoma–Associated Herpesvirus

“…Prior systematic studies of immunoblastic lymphomas in HIVinfected persons relied exclusively on polymerase chain reaction to detect Kaposi's sarcoma-associated herpesvirus (2,(7)(8)(9). In those studies, given that Kaposi's sarcoma-associated herpesvirus was absent or present at low levels in a few cases, infection of tumor cells and infection of rare normal bystander lymphocytes could not be distinguished.…”

“…Kaposi's sarcoma-associated herpesvirus is less clearly involved in other non-Hodgkin's lymphoma types. In large pathology-based studies (2, 7-9), 0 -22% of AIDS-associated immunoblastic lymphomas were Kaposi's sarcoma-associated herpesvirus positive by polymerase chain reaction (2,(7)(8)(9). However, these studies had very few AIDSassociated immunoblastic lymphomas, and Kaposi's sarcoma-associated herpesvirus appeared to be present at a low level in positive specimens, leaving its role uncertain.…”

Non-Hodgkin lymphoma in HIV-infected patients in the era of highly active antiretroviral therapy

“…6,22 In contrast to these, NHL is a heterogeneous entity with a multifactorial pathogenesis with no single causal agent documented so far, though Ebstein-Barr virus and human herpes virus type 8 have been associated with development of PBL and body cavity-based lymphoma. 8,[23][24][25] However, having accumulated longer follow-up we have found that the incidence of NHL does decrease with longer time on HAART.…”

Cancers associated with Kaposi's sarcoma (KS) in AIDS: a link between KS herpesvirus and immunoblastic lymphoma

“…In their original description of KSHV in primary effusion lymphoma, Cesarman et al did not find KSHV in any of 8 other AIDS-associated lymphomas characterized as 'immunoblastic plasmacytoid' in histology (Cesarman et al, 1995). Other investigators subsequently found KSHV in 17-22% of IBLs arising outside the pleura (Otsuki et al, 1996;Gessain et al, 1997;Boye Hansen et al, 2000). The level of KSHV in positive cases was low, raising the possibility that the virus was present only in normal circulating B lymphocytes within these tumours.…”