Malignant lymphoreticular lesions in patients with immune disorders resembling acquired immunodeficiency syndrome (AIDS): review of 80 cases

Abstract

Reports of high-grade non-Hodgkin's lymphoma, Hodgkin's disease, and lymphocytic leukemia in patients with acquired immunodeficiency syndrome (AIDS) or AIDS-like immune disorders have been increasing. In some cases, histologic alterations of lymph node architecture may precede the development of malignant lesions. Early in the course of the disease, clinical profiles of these patients are indistinguishable from those of patients with AIDS-associated opportunistic infections, but rapidly evolving extranodal lesions often signify the establishment of a lymphoproliferative neoplastic process. The frequent involvement of the central nervous system is responsible for the dismal outcome of the disease in a significant number of patients. A high death rate and poor response to antineoplastic agents have often characterized the course of non-Hodgkin's lymphoma and leukemia, but some patients with Hodgkin's disease have had a favorable response to treatment and a long survival. Aggressive multidisciplinary treatment may effectively avert the devastating consequences of this array of lymphoreticular neoplasms. Studies of these intriguing disorders may provide a better understanding of the interrelationships of infection, immunity, and oncogenesis in man.