AIDS-related primary pulmonary lymphoma.
We describe 12 cases of AIDS-related primary pulmonary lymphoma occurring between 1986 and 1996 in a large French cohort of HIV-infected patients. Diagnostic criteria were: (1) histologically proven lymphomatous pulmonary involvement; (2) absence of mediastinal and/or hilar adenopathy on chest radiography; (3) absence of extrathoracic lymphoma extension. All patients were severely immunodeficient at the time of diagnosis. All but one patient presented with B and/or nonspecific respiratory symptoms. Chest radiography showed one or more marginated nodule(s) or large mass. CT scan showed a cavitary lesion in five patients. No lymph node enlargement or specific pleural effusion was detected. Transthoracic needle biopsies were performed in 10 patients and avoided open-lung biopsy for the diagnosis of lymphoma in five patients. All but one of the primary pulmonary lymphoma were high-grade B-cell non-Hodgkin's lymphomas. Using antilatent membrane protein-1 antibodies and an Epstein-Barr-Virus-encoded RNA transcript-specific probe, latent EBV infection of tumor cells was demonstrated in every case. All but one of the patients received chemotherapy. The median survival time was 4 mo, and no patient was still alive at the cut-off date for this analysis. Progessive pulmonary lymphoma was the main cause of death, but infections were also frequent.
Services de Pneumologie et de Réanimation Respiratoire et Service d'Anatomie-Pathologique, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France.
P
P
Ray
M
M
Antoine
M
M
Mary-Krause
M G
MG
Lebrette
M
M
Wislez
C
C
Duvivier
M C
MC
Meyohas
P M
PM
Girard
C
C
Mayaud
J
J
Cadranel
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000328:Adult; D000956:Antigens, Viral / Q000032:analysis; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D015331:Cohort Studies; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015658:HIV Infections; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000276:immunology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000175:diagnosis; D012367:RNA, Viral / Q000032:analysis; D013902:Radiography, Thoracic; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014763:Viral Matrix Proteins / Q000032:analysis
D000956:Antigens, Viral; D000970:Antineoplastic Agents; C037662:EBV-associated membrane antigen, Epstein-Barr virus; D012367:RNA, Viral; D014763:Viral Matrix Proteins