Acquired immunodeficiency syndrome-associated T-cell lymphoma: evidence for human immunodeficiency virus type 1-associated T-cell transformation.
The majority of lymphomas in the setting of acquired, iatrogenic, or congenital immunodeficiencies are B-cell lymphoproliferations. We describe a rare T-cell lymphoma in a fulminantly ill patient infected with human immunodeficiency virus type 1 (HIV-1). The T-cell nature of the process was defined genotypically (monoclonal T-cell receptor beta-chain [CT beta] rearrangement) and phenotypically (CD45RO+, CD4+, CD5+, CD25+, CD8-, CD3- and negative for a variety of B-cell and monocyte markers). The CD4+, CD25+ (interleukin-2 receptor [IL-2R]) phenotype with production of IL-2 and IL-2R RNA is analogous to human T-lymphotropic virus type I (HTLV-I)-associated adult T-cell leukemia/lymphoma (ATLL); however, no HTLV-1 could be detected. Southern blot analysis did demonstrate monoclonally integrated HIV-1 within the tumor genome. Furthermore, the tumor cells were producing HIV p24 antigen as shown by immunohistochemistry. This is the first case of acquired immunodeficiency syndrome (AIDS)-associated non-Hodgkin's lymphoma in which HIV-1 infection may have played a central role in the lymphocyte transformation process.
Herndier
B G
BG
Department of Pathology, University of California, San Francisco.
Shiramizu
B T
BT
Jewett
N E
NE
Aldape
K D
KD
Reyes
G R
GR
McGrath
M S
MS
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001483:Base Sequence; D015139:Blotting, Southern; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D002472:Cell Transformation, Viral; D004279:DNA, Viral / Q000032:analysis; D015333:Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; D015497:HIV-1; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D016130:Immunophenotyping; D007376:Interleukin-2 / Q000235:genetics; D008168:Lung / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012313:RNA / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology
D004279:DNA, Viral; D007376:Interleukin-2; D012313:RNA