Aids related lymphomas
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Aids related lymphomas






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    Aids related lymphomas Aids related lymphomas Presentation Transcript

    • AIDS-related lymphomas
    • HIV-associated diseases of hematopoietic system
      • lymphadenopathy, anemia, leukopenia, thrombocytopenia, neoplasms
      • several potential etiologic factors
        • direct result of HIV (but currently there is no convincing evidence of HIV directly causing malignant transformation)
        • manifestations of secondary infections and neoplasms
        • side effects of therapy
    • HIV-associated neoplasm of hematopoietic system pathophysiologic mechanism
      • sustained polyclonal B-cell activation
      •  emergence of monoclonal or oligoclonal B-cell population
      • high levels of cytokines in AIDS patients (IL-6 = growth factor for B-cells)
      • EBV (= polyclonal mitogen for B-cells) found in 50% of systemic lymphomas and 100% of primary CNS lymphomas
    • AIDS-related lymphomas
      • at least 6% of all patients with AIDS develop lymphoma at some time during the course of illness (120-fold increase in incidence)
      • lymphoma is a late manifestation of HIV infection
      • as HIV disease progresses, the risk of lymphomas increases
    • AIDS-related lymphomas
      • three groups (based on location)
        • systemic
        • primary central nervous system
        • body cavity-based
      • two major histological groups
        • immunoblastic lymphoma
        • small non-cleaved cell lymphoma (Burkitt lymphoma)
      • KSHV(KS herpes virus)(HSV 8)
      • associated with some body cavity-based B-cell lymphoma
    • immunoblastic lymphomas
      • account for ~60% of the cases of lymphoma in AIDS patients
      • generally high grade
      • more commonly seen in older patients
      • body cavity-based lymphoma
        • variant of immunoblastic lymphoma
    • body cavity-based lymphoma
      • variant of immunoblastic lymphoma
      • presents with lymphomatous pleural, pericardial, and/or peritoneal effusions
      • absence of discrete nodal or extranodal masses
      • human herpes virus type 8 DNA sequences have been found in the tumor cell genome
    • small non-cleaved cell lymphoma (Burkitt lymphoma)
      • accounts for ~20% of lymphomas in AIDS
      • most frequently seen in patients 10 to 19 years old
      • usually demonstrates characteristic c-myc translocations from CH8 to CH14 or 22
      • >1000-fold increase in incidence
      • ~50% of cases associated with EBV
    • primary CNS lymphoma
      • accounts for ~20% of AIDS lymphomas
      • usually positive of EBV
      • no specific age predilection
      • focal neurologic deficits
          • cranial nerve abnormalities
          • headache
          • seizure
      • one to three 3- to 5-cm lesions
      • located deep in white matter
    • systemic lymphoma
      • seen earlier stage in HIV infection than primary CNS lymphoma
      • involves GI tract, bone marrow, liver, lung
          • GI tract : ~25% of patients
          • bone marrow: ~20% of patients
          • liver & lung: ~10% of patients