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Clinical analysis of 10 AIDS patients with malignant lymphoma.

Gao GJ, Yang D, Lin KK, Xiao J, Li X, Liang HY, Liu L, Han N, Zhao HX - Cancer Biol Med (2012)

Bottom Line: Six patients took HAART, and 4 did not.Six patients died, whereas 3 patients got improved; and 1 patient was discharged.HAART failed to improve patient prognosis, and the overall prognosis was poor.

View Article: PubMed Central - PubMed

Affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

ABSTRACT

Objective: This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma.

Methods: A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathological examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed.

Results: The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3 cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma (DLBCL), and 3 patients were pathologically diagnosed with Burkitt's lymphoma. Up to 8 patients had CD4 cell counts below 200/µL, and 2 patients had a level of more than 200/µL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were not examined. Six patients underwent different chemotherapy and their prognoses were different. One patient with Burkitt's lymphoma alternatively took CODOXM and IVAC for 3 turns after VP chemotherapy; 1 patient with liver metastasis took R-CHOP 5 times, then changed therapy regimen to R-MINE and MINE. One patient with adrenal DLBCL took CHOP 6 times. Three patients with DLBCL took CHOP 1 or 2 times. Four patients gave up treatment. Various infections and side effects occurred, including bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAART, and 4 did not. Six patients died, whereas 3 patients got improved; and 1 patient was discharged.

Conclusions: AIDS patients with malignant lymphoma had various clinical manifestations, were immunocompromised, and had multiple metastases when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional complications occurred. HAART failed to improve patient prognosis, and the overall prognosis was poor.

No MeSH data available.


Related in: MedlinePlus

A: Case 10 (narrow intestinal lumen 35-40 cm from the anus). Four miliary colonic tissue samples were collected, one of which showed active chronic inflammation. A heterocyst can be seen in the other three pieces; B: Case 7 (punctate smear of cervical lymph nodes). A large quantity of dysplastic lymphoblasts indicated diffuse large B cell lymphoma. Immunohistochemistry: CD20(+), CD3(-), CD10(-), MUM-1(-), Bcl-6(-), Ki-67(-), Lambda(±), Kappa(±); C: Case 6 (punctate smear of lymph nodes). Cellular degeneration was obvious. Small quantities of dyskaryotic cells, and sometimes nuclear division figures were observed; D: Case 5 (galactophore puncture cell mass). Burkitt’s lymphoma. Immunohistochemistry: CD56(-),CK AE1/3(-), LCA(CD45)(+), CD3(-), CD20(+), CD10(+), Mum-1(-), Bcl-6(-), ki-67 (diffuse+); E: Case 2 (lower part of stomach), two miliary fundus glands from gastric mucosal tissues. Large quantities of atypical lymphocytes infiltrated into the mucosa, indicating non-Hodgkin’s diffuse large B cell lymphoma. Immunohistochemistry: tumor cell Bcl-6(+), CD10(+), CD20(+), CD3(-), CK AE1/3(-), Ki-67(+), Mum-1(+); F: Case 1 (left axillary lymph node). Needle aspiration cell mass: most active hyperplastic lymphocytes were active mother cells. Combined with immunohistochemistry, the lesion was diagnosed as Burkitt’s lymphoma. Immunohistochemistry: Bcl-6(+), CD10(+), CD20(+), CD3(-), Ki-67(+), Mum-1(-); G: Case 4. Fine-needle aspiration cytology: a single allotype macrolymphocyte indicated lymphoma. Combined with the immunohistochemistry result, the lesion was diagnosed as diffuse large B cell lymphoma. Immunohistochemistry: CK AE1/3(-), CD20(+++).
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f1: A: Case 10 (narrow intestinal lumen 35-40 cm from the anus). Four miliary colonic tissue samples were collected, one of which showed active chronic inflammation. A heterocyst can be seen in the other three pieces; B: Case 7 (punctate smear of cervical lymph nodes). A large quantity of dysplastic lymphoblasts indicated diffuse large B cell lymphoma. Immunohistochemistry: CD20(+), CD3(-), CD10(-), MUM-1(-), Bcl-6(-), Ki-67(-), Lambda(±), Kappa(±); C: Case 6 (punctate smear of lymph nodes). Cellular degeneration was obvious. Small quantities of dyskaryotic cells, and sometimes nuclear division figures were observed; D: Case 5 (galactophore puncture cell mass). Burkitt’s lymphoma. Immunohistochemistry: CD56(-),CK AE1/3(-), LCA(CD45)(+), CD3(-), CD20(+), CD10(+), Mum-1(-), Bcl-6(-), ki-67 (diffuse+); E: Case 2 (lower part of stomach), two miliary fundus glands from gastric mucosal tissues. Large quantities of atypical lymphocytes infiltrated into the mucosa, indicating non-Hodgkin’s diffuse large B cell lymphoma. Immunohistochemistry: tumor cell Bcl-6(+), CD10(+), CD20(+), CD3(-), CK AE1/3(-), Ki-67(+), Mum-1(+); F: Case 1 (left axillary lymph node). Needle aspiration cell mass: most active hyperplastic lymphocytes were active mother cells. Combined with immunohistochemistry, the lesion was diagnosed as Burkitt’s lymphoma. Immunohistochemistry: Bcl-6(+), CD10(+), CD20(+), CD3(-), Ki-67(+), Mum-1(-); G: Case 4. Fine-needle aspiration cytology: a single allotype macrolymphocyte indicated lymphoma. Combined with the immunohistochemistry result, the lesion was diagnosed as diffuse large B cell lymphoma. Immunohistochemistry: CK AE1/3(-), CD20(+++).

Mentions: Please see Table 2 and Figure 1.


Clinical analysis of 10 AIDS patients with malignant lymphoma.

Gao GJ, Yang D, Lin KK, Xiao J, Li X, Liang HY, Liu L, Han N, Zhao HX - Cancer Biol Med (2012)

A: Case 10 (narrow intestinal lumen 35-40 cm from the anus). Four miliary colonic tissue samples were collected, one of which showed active chronic inflammation. A heterocyst can be seen in the other three pieces; B: Case 7 (punctate smear of cervical lymph nodes). A large quantity of dysplastic lymphoblasts indicated diffuse large B cell lymphoma. Immunohistochemistry: CD20(+), CD3(-), CD10(-), MUM-1(-), Bcl-6(-), Ki-67(-), Lambda(±), Kappa(±); C: Case 6 (punctate smear of lymph nodes). Cellular degeneration was obvious. Small quantities of dyskaryotic cells, and sometimes nuclear division figures were observed; D: Case 5 (galactophore puncture cell mass). Burkitt’s lymphoma. Immunohistochemistry: CD56(-),CK AE1/3(-), LCA(CD45)(+), CD3(-), CD20(+), CD10(+), Mum-1(-), Bcl-6(-), ki-67 (diffuse+); E: Case 2 (lower part of stomach), two miliary fundus glands from gastric mucosal tissues. Large quantities of atypical lymphocytes infiltrated into the mucosa, indicating non-Hodgkin’s diffuse large B cell lymphoma. Immunohistochemistry: tumor cell Bcl-6(+), CD10(+), CD20(+), CD3(-), CK AE1/3(-), Ki-67(+), Mum-1(+); F: Case 1 (left axillary lymph node). Needle aspiration cell mass: most active hyperplastic lymphocytes were active mother cells. Combined with immunohistochemistry, the lesion was diagnosed as Burkitt’s lymphoma. Immunohistochemistry: Bcl-6(+), CD10(+), CD20(+), CD3(-), Ki-67(+), Mum-1(-); G: Case 4. Fine-needle aspiration cytology: a single allotype macrolymphocyte indicated lymphoma. Combined with the immunohistochemistry result, the lesion was diagnosed as diffuse large B cell lymphoma. Immunohistochemistry: CK AE1/3(-), CD20(+++).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC3643651&req=5

f1: A: Case 10 (narrow intestinal lumen 35-40 cm from the anus). Four miliary colonic tissue samples were collected, one of which showed active chronic inflammation. A heterocyst can be seen in the other three pieces; B: Case 7 (punctate smear of cervical lymph nodes). A large quantity of dysplastic lymphoblasts indicated diffuse large B cell lymphoma. Immunohistochemistry: CD20(+), CD3(-), CD10(-), MUM-1(-), Bcl-6(-), Ki-67(-), Lambda(±), Kappa(±); C: Case 6 (punctate smear of lymph nodes). Cellular degeneration was obvious. Small quantities of dyskaryotic cells, and sometimes nuclear division figures were observed; D: Case 5 (galactophore puncture cell mass). Burkitt’s lymphoma. Immunohistochemistry: CD56(-),CK AE1/3(-), LCA(CD45)(+), CD3(-), CD20(+), CD10(+), Mum-1(-), Bcl-6(-), ki-67 (diffuse+); E: Case 2 (lower part of stomach), two miliary fundus glands from gastric mucosal tissues. Large quantities of atypical lymphocytes infiltrated into the mucosa, indicating non-Hodgkin’s diffuse large B cell lymphoma. Immunohistochemistry: tumor cell Bcl-6(+), CD10(+), CD20(+), CD3(-), CK AE1/3(-), Ki-67(+), Mum-1(+); F: Case 1 (left axillary lymph node). Needle aspiration cell mass: most active hyperplastic lymphocytes were active mother cells. Combined with immunohistochemistry, the lesion was diagnosed as Burkitt’s lymphoma. Immunohistochemistry: Bcl-6(+), CD10(+), CD20(+), CD3(-), Ki-67(+), Mum-1(-); G: Case 4. Fine-needle aspiration cytology: a single allotype macrolymphocyte indicated lymphoma. Combined with the immunohistochemistry result, the lesion was diagnosed as diffuse large B cell lymphoma. Immunohistochemistry: CK AE1/3(-), CD20(+++).
Mentions: Please see Table 2 and Figure 1.

Bottom Line: Six patients took HAART, and 4 did not.Six patients died, whereas 3 patients got improved; and 1 patient was discharged.HAART failed to improve patient prognosis, and the overall prognosis was poor.

View Article: PubMed Central - PubMed

Affiliation: Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.

ABSTRACT

Objective: This work summarizes the clinical features and treatment of 10 AIDS patients with malignant lymphoma.

Methods: A total of 10 AIDS patients with malignant lymphoma seen in Beijing Ditan Hospital since 2009 were enrolled. Clinical manifestations, pathological examinations, immunity levels, Epstein-Barr virus antibody examinations, complications, treatments, and outcomes were retrospectively analyzed.

Results: The main clinical manifestations of these patients included intermittent fever in 2 cases, neck masses and fever in 3 cases, auxiliary lymph node enlargement in 2 cases, and abdominal pain and bloating with fever in 3 cases. Up to 7 patients were pathologically diagnosed with diffuse large B cell lymphoma (DLBCL), and 3 patients were pathologically diagnosed with Burkitt's lymphoma. Up to 8 patients had CD4 cell counts below 200/µL, and 2 patients had a level of more than 200/µL. Up to 7 patients were negative for EBV-IgM antibodies and 3 patients were not examined. Six patients underwent different chemotherapy and their prognoses were different. One patient with Burkitt's lymphoma alternatively took CODOXM and IVAC for 3 turns after VP chemotherapy; 1 patient with liver metastasis took R-CHOP 5 times, then changed therapy regimen to R-MINE and MINE. One patient with adrenal DLBCL took CHOP 6 times. Three patients with DLBCL took CHOP 1 or 2 times. Four patients gave up treatment. Various infections and side effects occurred, including bone marrow suppression, gastrointestinal bleeding, and renal dysfunction during chemotherapy. Six patients took HAART, and 4 did not. Six patients died, whereas 3 patients got improved; and 1 patient was discharged.

Conclusions: AIDS patients with malignant lymphoma had various clinical manifestations, were immunocompromised, and had multiple metastases when they were admitted; they were already in the interim or late stage of lymphoma. Chemotherapy was not effective, and additional complications occurred. HAART failed to improve patient prognosis, and the overall prognosis was poor.

No MeSH data available.


Related in: MedlinePlus