[Primary central nervous system lymphomas in AIDS patients].
BACKGROUND
Primary lymphoma is the most common neoplasm of the central nervous system (CNS) in AIDS patients.


METHODS
We retrospectively reviewed the clinical manifestations, neuroimaging findings, diagnostic methods used, histological characteristics, detection of Epstein-Barr virus (EBV) DNA by PCR in cerebrospinal fluid (CSF) and brain smears, and outcome of 18 HIV/AIDS patients with primary CNS lymphoma.


RESULTS
The overall incidence of primary CNS lymphoma was 2.6%. Fifteen were men and mean age was 33.6 years. The most frequent clinical findings were focal neurological deficits and seizures. The mean CD4 T cell count at the time of diagnosis was 44 cells/microl. Primary CNS lymphoma presented as single, large (> 2.5 cm) lesions in 14 patients (77.8%). All the lesions were associated with a mass effect and surrounding edema. EBV DNA was detected in nine brain smears. In seven of these nine cases, EBV DNA was also found in CSF by PCR. Median survival after specific diagnosis was 75 days.


CONCLUSIONS
This study upholds a link between EBV and these tumors. Primary CNS lymphoma was associated with a poor prognosis and short survival in this cohort of patients.
Corti
Marcelo
M
Unidad 10 y Laboratorio de Anatomía Patológica, Hospital de Enfermedades Infecciosas F.J. Muñiz, Instituto de Investigaciones Oncohematológicas, Academia Nacional de Medicina, Buenos Aires, Argentina. marcelocorti@ciudad.com.ar
Villafañe
Florencia
F
Trione
Norberto
N
Schtirbu
Ricardo
R
Yampolsky
Claudio
C
Narbaitz
Marina
M
D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001706:Biopsy; D001921:Brain / Q000473:pathology / Q000821:virology; D001923:Brain Chemistry; D001929:Brain Edema / Q000209:etiology; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis / Q000134:cerebrospinal fluid; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D016483:Lymphoma, AIDS-Related / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008228:Lymphoma, Non-Hodgkin / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology; D013238:Stereotaxic Techniques; D015173:Supratentorial Neoplasms / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016019:Survival Analysis; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis
D004279:DNA, Viral