Polyclonal polymorphic B-cell lymphoproliferative disorder with prominent pulmonary involvement in children with acquired immune deficiency syndrome

Joshi, Vijay V.; Kauffman, Shirley L.; Oleske, James M.; Fikrig, Senih; Denny, Thomas N.; Gadol, C.; Lee, Eun

doi:10.1002/1097-0142(19870415)59:8<1455::aid-cncr2820590811>3.0.co;2-d

Cited by 76 publications

(14 citation statements)

References 13 publications

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“…However, in rare cases, progression to a polyclonal polymorphic B-cell lymphoproliferative disorder (PBLD) with systemic involvement may be seen, affecting lung, lymph nodes, liver, kidneys, spleen, and other tissues. Two children in our series demonstrated this progression (21). As indicated above, children with PLH/LIP complex survive for longer periods than those with OIs, but the more favorable prognosis is tempered because of the rare possibility of progression to PBLD.…”

Section: Associated Lesionssupporting

confidence: 57%

Morphologic Findings in Children with Acquired Immune Deficiency Syndrome: Pathogenesis and Clinical Implications

Joshi¹,

Oleske

Connor³

1990

Pediatric Pathology

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The lesions observed in biopsy and autopsy material from children with the acquired immunodeficiency syndrome (AIDS) can be divided into three pathogenetic categories: primary lesions related to infection by human immunodeficiency virus (HIV) (e.g., lymphoreticular system and brain); lesions due to the sequelae of HIV infection (e.g., opportunistic infections, pulmonary lymphoid lesions, etc.); and lesions of undetermined pathogenesis (e.g., renal lesions, cardiomyopathy, etc.). The role of morphologic studies in AIDS in understanding the pathogenesis of the various lesions and their clinical implications are discussed by describing the following examples among others. Study of the thymus enabled us to distinguish AIDS from some congenital immune deficiency syndromes. Thymic injury contributes to immunodeficiency in AIDS. Its apparent irreversibility will have to be considered in the long-term management of children with AIDS when specific effective therapy for HIV becomes available. Demonstration of HIV--like particles in the characteristic giant cells in the brain has been instrumental in the recognition of HIV encephalopathy. Biopsy is helpful in the rapid diagnosis of opportunistic infections (OIs). Autopsy study of OIs has shown involvement of clinically unsuspected organs, such as the adrenals. Characterization of the pulmonary lymphoid lesions led to their inclusion as a diagnostic criterion for AIDS in children. Progression of pulmonary lymphoid lesions to a lymphoproliferative disorder was demonstrated at autopsy. Recognition of lesions such as cardiomyopathy and arteriopathy at autopsy should alert clinicians to suspect these disorders during life.

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Section: Associated Lesionssupporting

confidence: 57%

Morphologic Findings in Children with Acquired Immune Deficiency Syndrome: Pathogenesis and Clinical Implications

Joshi¹,

Oleske

Connor³

1990

Pediatric Pathology

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“…Other polyclonal, polymorphic, and B cell lymphoproliferative disorders have been reported in children with HIV infection [2][3][4]. One report described a 14-year-old boy with congenital HIV infection, lymphadenopathy, and interstitial pulmonary infiltrates.…”

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confidence: 99%

“…Another report described 4 children with AIDS and abnormal lymphoproliferative growth [3]. One patient had lymphoid interstitial pneumonitis, and 3 of the patients were described as having lymph nodes that contained effaced architecture due to a polyclonal, polymorphous lymphoid cell infiltration.…”

mentioning

confidence: 99%

Reactive Epstein-BarrVirus--Related Polyclonal Lymphoproliferative Disorder in a Patient with AIDS

Martin¹,

Zukerberg²,

Robbins³

2005

Clinical Infectious Diseases

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Reactivation of Epstein-Barr virus infection and polyclonal expansion of lymphocytes is well-documented in solid organ and hematopoietic stem cell transplant recipients and is considered a potential precursor to lymphoma. We report an analogous case of posttransplantation polyclonal lymphoproliferative disorder in a patient with human immunodeficiency virus infection who was successfully treated with antiretroviral therapy.

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“…Notably, these uncommon lesions are often analogous to the polymorphic subtype of post-transplantation lymphoproliferative disorder [1][2][3][4][5][6][7][8][9][10]. To date, their clinicopathological features and pathogenesis are still poorly determined.…”

Section: Introductionmentioning

confidence: 99%

Atypical Hyperplasia of the Marginal Zone of B Follicles in a Polymorphic Epstein-Barr Virus–Associated Lymphoproliferative Disorder Occurring in an Adolescent with Human Immunodeficiency Virus Infection

et al. 2009

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Epstein-Barr virus (EBV)-associated lymphoid proliferations that are similar to post-transplantation lymphoproliferative disorders may occasionally occur in the setting of human immunodeficiency virus (HIV) infection. Herein, we describe such a lesion involving the adenoids in a HIV-seropositive adolescent who acquired immunity against EBV during childhood. On microscopic examination, the marginal zone of B follicles and the interfollicular area were enlarged due to the accumulation of small or intermediate-sized lymphocytes, immunoblasts, epithelioid histiocytes, and plasma cells. A few atypical immunoblasts resembling Reed-Sternberg cells were also present. Most of the cells seen in these expanded regions belonged to the B-cell lineage and displayed a phenotype consistent with that of postgerminal center B cells. No clonal rearrangement of the genes coding for the heavy chain of the immunoglobulin could be demonstrated by polymerase chain reaction analysis. In-situ hybridization studies revealed the presence of EBV early RNA in a significant number of these cells, which suggests the participation of this virus in the pathogenesis of such a B-cell proliferation. The clinical course was benign; no progression or recurrence could be seen more than 24 months after the diagnosis. This atypical lymphoproliferative disorder is probably related to polyclonal reactivation of a latent EBV infection due to a local or systemic immune imbalance induced by HIV replication. Recognition of this reactive condition is important to prevent overtreatment.

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Polyclonal polymorphic B-cell lymphoproliferative disorder with prominent pulmonary involvement in children with acquired immune deficiency syndrome

Cited by 76 publications

References 13 publications

Morphologic Findings in Children with Acquired Immune Deficiency Syndrome: Pathogenesis and Clinical Implications

Morphologic Findings in Children with Acquired Immune Deficiency Syndrome: Pathogenesis and Clinical Implications

Reactive Epstein-BarrVirus--Related Polyclonal Lymphoproliferative Disorder in a Patient with AIDS

Atypical Hyperplasia of the Marginal Zone of B Follicles in a Polymorphic Epstein-Barr Virus–Associated Lymphoproliferative Disorder Occurring in an Adolescent with Human Immunodeficiency Virus Infection

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