Virchows Archiv

, Volume 461, Issue 1, pp 93–98

Polymorphic lymphoid proliferations occurring in HIV-positive patients: report of a case responding to HAART

Case Report

Abstract

Epstein–Barr virus (EBV)-associated polymorphic lymphoid proliferations resembling polymorphic post-transplant lymphoproliferative disorders are a rare but recognised complication of the human immunodeficiency virus (HIV). These account for fewer than 5 % of HIV-associated lymphomas, and little information has been published regarding their treatment and outcome. Of the reported cases, many have presented with extranodal disease, not typical of lymphoma. We report the case of a patient presenting with lung infiltrates shown to be the result of an EBV-associated polymorphic lymphoproliferation resembling a polymorphic post-transplant lymphoproliferative disorder. The patient was simultaneously found to be HIV positive and commenced on highly active antiretroviral therapy. Without any specific anti-neoplastic treatment, the patient recovered completely and within 20 months had no symptoms or radiological evidence of a lymphoproliferative disorder. This illustrates the importance of recognising this uncommon condition in HIV-positive patients and avoiding potentially unnecessary chemotherapy.

Keywords

Immunodeficiency-associated lymphoproliferative disorder Post-transplant lymphoproliferative disorder Human immunodeficiency virus (HIV) Epstein–Barr virus (EBV) Antiretroviral therapy 

References

  1. 1.
    Nador RG, Chadburn A, Gundappa G et al (2003) Human immunodeficiency virus (HIV)-associated polymorphic lymphoproliferative disorders. Am J Surg Pathol 27(3):293–302PubMedCrossRefGoogle Scholar
  2. 2.
    Raphael M, Said J, Borisch B et al (2008) Immunodeficiency-associated lymphoproliferative disorders. In: Swerdlow SH, Campo E, Harris NL et al (eds) WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edn. International Agency for Research on Cancer, Lyon, pp 335–352Google Scholar
  3. 3.
    Grogg KL, Miller RF, Dogan A (2007) HIV infection and lymphoma. J Clin Pathol 60:1365–1372PubMedCrossRefGoogle Scholar
  4. 4.
    Tao J, Valderrama E (1999) Epstein–Barr virus-associated polymorphic B-cell lymphoproliferative disorder in the lungs of children with AIDS: a report of two cases. Am J Surg Pathol 23(5):560–566PubMedCrossRefGoogle Scholar
  5. 5.
    Fujita H, Nishikori M, Takaori-Kondo A et al (2010) A case of HIV-associated lymphoproliferative disease that was successfully treated with highly active antiretroviral therapy. Int J Hematol 91:692–698PubMedCrossRefGoogle Scholar
  6. 6.
    Kingma DW, Mueller BU, Frekko K et al (1999) Low-grade monoclonal Epstein–Barr virus associated lymphoproliferative disorder of the brain presenting as human immunodeficiency virus-associated encephalopathy in a child with acquired immunodeficiency syndrome. Arch Pathol Lab Med 123:83–87PubMedGoogle Scholar
  7. 7.
    Wang X, Nathan S, Catchatourian R, Richter H III, Kovarik P (2007) Polymorphic lymphoid proliferation presenting as ileocecal intussusception. Ann Hematol 86:453–454PubMedCrossRefGoogle Scholar
  8. 8.
    Martin SI, Zukerberg L, Robbins G (2005) Reactive Epstein–Barr virus-related polyclonal lymphoproliferative disorder in a patient with AIDS. Clin Infect Dis 41:e76–e79PubMedCrossRefGoogle Scholar
  9. 9.
    Gucalp A, Noy A (2009) Spectrum of HIV lymphoma. Curr Opin Hematol 17:362–367CrossRefGoogle Scholar
  10. 10.
    Hoffmann C, Wolf E, Fatkenheuer G et al (2003) Response to highly active antiretroviral therapy strongly predicts outcome in patients with AIDS-related lymphoma. AIDS 17:1521–1529PubMedCrossRefGoogle Scholar
  11. 11.
    Oppenheim S (2009) Prognosis in HIV-associated malignancies #214. J Palliat Med 12(9):835–836PubMedCrossRefGoogle Scholar
  12. 12.
    Monini P, Sgadari C, Toschi E et al (2004) Antitumour effects of antiretroviral therapy. Cancer 4:861–875PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of HaematologyWestern General HospitalEdinburghUK
  2. 2.Regional Infectious Diseases UnitWestern General HospitalEdinburghUK
  3. 3.Department of PathologyWestern General HospitalEdinburghUK

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