Pathology of lymphoma in HIV

Abstract

Purpose of review Individuals with HIV infection have a greatly increased risk of developing malignancies, even when HIV infection is successfully controlled with antiretrovirals. Non-Hodgkin’s lymphoma is considered an AIDS-defining entity, and this disease is currently the most common type of cancer in HIV-infected individuals in the US and Europe. Here we describe the different types of lymphomas occurring in individuals with AIDS, and the most relevant pathologic features helpful for histologic and immunohistochemical diagnosis. Recent findings The incidence of some AIDS-related lymphoma subtypes has changed since the introduction of combined antiretroviral therapy, and some of the diagnostic methodologies have evolved. New biomarkers of disease have been identified, which may be useful for diagnosis. Summary Better pathological classification strategies and deeper molecular understanding of the different lymphoma subtypes that occur in people with AIDS will begin to allow the transition to more precise diagnosis and targeted treatments.

When to use in situ hybridization for the detection of Epstein-Barr virus: a review of Epstein-Barr virus-associated lymphomas

“…To date, EBV has been demonstrated to be associated with Hodgkin lymphoma [11,12], nasal-type ENKTL [13][14][15], PAL [16][17][18], and immunodeficiency-associated lymphoproliferative disorders [3][4][5]. In the updated World Health Organization (WHO) classification, 15 diseases are listed as EBV-associated lymphoproliferative disorders [20] (Table 1).…”

“…They are also assumed to be associated with lymphomas developing in immunocompromised hosts [3][4][5], for example, human T-lymphotropic virus type 1 has been associated with adult T cell leukemia/lymphoma (ATLL) [6], human herpesvirus type 8 (HHV-8) with primary effusion lymphoma (PEL) [7], hepatitis C virus with lymphoplasmacytic lymphoma [8], and simian virus 40 with diffuse large B cell lymphoma (DLBCL) [9]. Particularly, information regarding the etiological role of EBV in B cell non-Hodgkin and Hodgkin lymphoma has been collected.…”

“…The positive rate of EBV is high in several types of lymphoma [10], including Burkitt lymphoma [1,2], lymphomas developing in immunocompromised hosts [3][4][5], Hodgkin lymphoma, particularly mixed cellularity subtype [11,12], nasal-type extranodal natural killer/T cell lymphoma (ENKTL) [13][14][15], and pyothorax-associated lymphoma (PAL) [16][17][18]. Thus, the detection of EBV could be useful for the diagnosis of these types of lymphomas.…”

Expression of HIV-1 matrix protein p17 and association with B-cell lymphoma in HIV-1 transgenic mice

“…There has been a shift from lymphomas associated with severe immunodeficiency and human herpesvirus (HHV)-4/EBV and HHV-8/Kaposi's sarcoma-associated herpesvirus (e.g., primary central nervous system lymphoma, primary effusion lymphoma, immunoblastic DLBCL) (3,5,6) to those associated with mild immunodeficiency (e.g., centroblastic DLBCL, BL, Hodgkin lymphoma), in which the frequency of EBV infection is lower. Whereas 30-40% of HIV-associated lymphomas are positive for EBV, the majority of cases develop independent of EBV and thus are dependent on other factors (7)(8)(9).…”

“…The mechanisms responsible for this increased risk have not been fully elucidated, but are thought to involve HIV-1-mediated impaired cellular immunity, loss of control over oncogenic viruses, and chronic B-cell activation. The major subtypes of HIV-associated lymphoma include diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL), characterized by c-myc activation (2,3).…”