HIV can increase the risk of developing lymphomas through sustained B-cell activation and high cytokine levels. AIDS-related lymphomas are categorized based on location into systemic, primary central nervous system, and body cavity-based types. The two major histological groups are immunoblastic lymphoma and small non-cleaved cell lymphoma (Burkitt lymphoma). Human herpes viruses have been linked to some forms of AIDS-related lymphomas.

1. AIDS-related lymphomas www.freelivedoctor.com

2. 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 www.freelivedoctor.com

3. 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 www.freelivedoctor.com

4. 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 www.freelivedoctor.com

5. 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 www.freelivedoctor.com

6. 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 www.freelivedoctor.com

7. 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 www.freelivedoctor.com

8. 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 www.freelivedoctor.com

9. 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 www.freelivedoctor.com

10. 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 www.freelivedoctor.com