Cutaneous CD8 T cell infiltrates in advanced HIV infection.
BACKGROUND
Aggressive non-Hodgkin's lymphomas are common among patients infected with HIV. Although such lymphomas are mostly of the B-cell type, various cases of cutaneous T-cell lymphoma (CTCL) have also been reported. Recent reports suggest that some HIV-related lymphoproliferative conditions may not be clonal processes, but polyclonal lymphoid proliferations.


OBJECTIVE
We reviewed our experience with HIV patients seen at the dermatology clinics for possible CTCL.


METHODS
A retrospective study was performed to evaluate clinical, laboratory, and histologic findings of HIV-infected patients with atypical T-cell cutaneous infiltrates.


RESULTS
We observed 9 patients with advanced HIV infection and a cutaneous eruption characterized by a dense infiltrate of lymphocytes resembling mycosis fungoides histopathologically, but composed of CD8(+) cells. Although clonality was not identified in any of the 6 cases tested, 3 patients had similar CD8(+) infiltrates involving lymph nodes or bone marrow. Of the 9 patients, 8 died of AIDS wasting syndrome or infections in less than 1 year.


CONCLUSIONS
Cutaneous and systemic infiltrates with polyclonal CD8 T lymphocytes can be seen in patients with advanced HIV infection and profound CD4 lymphopenia. The clinical presentation may resemble CTCL and is associated with a poor outcome.
Guitart
J
J
Department of Dermatology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Variakojis
D
D
Kuzel
T
T
Rosen
S
S
D000328:Adult; D018414:CD8-Positive T-Lymphocytes; D018450:Disease Progression; D015658:HIV Infections / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes; D016246:Lymphocytes, Tumor-Infiltrating; D016483:Lymphoma, AIDS-Related / Q000473:pathology*; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*