Lymphoma, AIDS-related

Lymphoma, AIDS-related

Lymphoma, AIDS-related, refers to a group of aggressive lymphoid neoplasms that occur in individuals with Acquired Immunodeficiency Syndrome (AIDS). These lymphomas are a significant cause of morbidity and mortality in patients with AIDS and are considered an AIDS-defining illness.

Pathophysiology

AIDS-related lymphomas are primarily associated with the profound immunosuppression caused by the Human Immunodeficiency Virus (HIV). The weakened immune system in HIV-infected individuals allows for the unchecked proliferation of B lymphocytes, often driven by oncogenic viruses such as Epstein-Barr Virus (EBV) and Human Herpesvirus 8 (HHV-8). These viruses contribute to the development of lymphomas by promoting cellular proliferation and inhibiting apoptosis.

Types of AIDS-related Lymphoma

AIDS-related lymphomas are typically classified into three main types:

• Diffuse Large B-Cell Lymphoma (DLBCL): This is the most common type of AIDS-related lymphoma. It is characterized by rapidly growing tumors that can occur in lymph nodes or extranodal sites such as the gastrointestinal tract, liver, and central nervous system.

• Burkitt Lymphoma: Known for its extremely rapid growth, Burkitt lymphoma often presents with abdominal masses and is associated with EBV infection.

• Primary Central Nervous System Lymphoma (PCNSL): This type of lymphoma is confined to the brain, spinal cord, or eyes and is also frequently associated with EBV.

Clinical Presentation

Patients with AIDS-related lymphoma may present with a variety of symptoms depending on the type and location of the lymphoma. Common symptoms include:

• Lymphadenopathy: Swollen lymph nodes, often painless.
• B symptoms: Fever, night sweats, and weight loss.
• Extranodal involvement: Symptoms related to the specific organ involved, such as abdominal pain, neurological deficits, or respiratory symptoms.

Diagnosis

The diagnosis of AIDS-related lymphoma involves a combination of clinical evaluation, imaging studies, and histopathological examination. A biopsy of the affected tissue is essential to confirm the diagnosis and to determine the specific type of lymphoma.

Treatment

The treatment of AIDS-related lymphoma typically involves combination chemotherapy regimens, often including drugs such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). The management of HIV infection with antiretroviral therapy (ART) is also crucial, as it helps to restore immune function and improve overall outcomes.

Prognosis

The prognosis of AIDS-related lymphoma has improved significantly with the advent of ART. However, it remains poorer compared to lymphomas in HIV-negative individuals due to factors such as advanced stage at diagnosis and concurrent opportunistic infections.

Also see

• HIV/AIDS
• Non-Hodgkin Lymphoma
• Epstein-Barr Virus
• Antiretroviral Therapy