Clonal ambiguity of human immunodeficiency virus-associated lymphomas. Similarity to posttransplant lymphomas.
Initial biopsy specimens from two patients with lymphadenopathy and human immunodeficiency virus antibody-positive serum presented considerable difficulty in making specific histologic and immunologic diagnoses, although subsequent biopsy specimens revealed clear progression to acquired immunodeficiency syndrome (AIDS)-associated lymphomas. The initial biopsy specimens revealed multifocal clusters of large blastic lymphoid cells, with some clusters showing a monoclonal lambda light chain predominance, whereas other clusters showed a kappa predominance, indicating considerable phenotypic ambiguity suggestive of polyclonality. This initial clonal ambiguity was followed within two to three months by overt histologic, phenotypic, and clinical malignant transformation to a diffuse high-grade monoclonal B-cell lymphoma. These data have significant implications for the clonality and pathogenesis of AIDS-associated lymphoproliferative disorders. AIDS-related lymphomas may evolve from an initial multiclonal B-cell expansion similar to that described in other severely immunosuppressed patients (eg, with posttransplantation lymphoma).
Lippman
S M
SM
Section of Hematology/Oncology, Arizona Cancer Center.
Volk
J R
JR
Spier
C M
CM
Grogan
T M
TM
D000386:AIDS-Related Complex / Q000473:pathology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D000943:Antigens, Differentiation / Q000032:analysis; D001402:B-Lymphocytes; D002999:Clone Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D008297:Male; D014181:Transplantation Immunology
D000943:Antigens, Differentiation