Anatomical site predilections of non-Hodgkin's lymphoma in human immunodeficiency virus infection: a report on 54 cases
Mwanda, O.W.; Whalen, C.; Scot, C.R.; Lederman, M.; Orem, J.; Banura, C.
East African Medical Journal 2004(8 Suppl): S90-S96
2004
ISSN/ISBN: 0012-835X PMID: 15622607 Document Number: 570111
Objective: To identify and describe the primary anatomic sites of non-Hodgkin's lymphoma arising in the setting of human immunodeficiency virus infection. Design: Prospective (ongoing) study. Setting: Kenyatta National Hospital, a referral and teaching hospital in Kenya. Subjects and Methods: Patients (n=54) with human immunodeficiency virus-associated non-Hodgkin's lymphoma managed at the Kenyatta National hospital from January 2001 to December 2003. Relevant clinical information obtained by medical history, physical examination and investigations. Results: Of the 54 patients studied, 29 (54%) were males and 25 (46%) females, with a median age of 36 and age range of 20 to 61 years. Fifty (93%) had high grade and four (7%) had intermediate grade lymphoma. Of 50 patients with high grade lymphoma, 15 (30%) had Burkitt's and the rest, large cell lymphoma. The stages at diagnosis were IV 35(65%), III 14(26%) and II 5(9%) and all had B symptoms. The primary sites at presentation to the hospital were peripheral nodes (16, 30%), abdominal (15, 28%), pectoral/chest wall (11, 20%), central nervous system (8, 15%) and systemic/generalized (4, 7%). Conclusion: This study demonstrates that there were preferred anatomical sites of involvement by HIV-associated non-Hodgkin's lymphomas and the involvement of pectoral/chest in this series may not be coincidental. Further, this study suggests that anatomical sites predilection may be due to the tendency of viral associated malignancies to home to specific anatomic sites and also due to the anatomy of the lymphoreticular system. Studying virus pathogenesis in malignancies should consider also the anatomic sites involved.