Singh B, Poluri A, Shaha A R, Michuart P, Har-El G, Lucente F E
Department of Otolaryngology, State University of New York-Health Science Center at Brooklyn, USA.
Am J Otolaryngol. 2000 Jan-Feb;21(1):10-3. doi: 10.1016/s0196-0709(00)80118-0.
Non-Hodgkin's lymphoma is the 2nd most common malignancy in human immunodeficiency virus (HIV)-infected patients. However, limited information regarding head and neck manifestations of non-Hodgkin's lymphoma is present in the literature. The aim of this article is to describe the head and neck manifestations of non-Hodgkin's lymphoma in HIV-infected patients and compare it with that seen in noninfected patients.
A case-control study was performed including 124 patients with non-Hodgkin's lymphoma presenting over a 5.5-year period to tertiary care center in a metropolitan location.
Overall, the anatomic distribution of non-Hodgkin's lymphoma is not altered in the presence of HIV infection with the head and neck region (63%) most often involved overall. However, within the head and neck region, extralymphatic disease is significantly more common in HIV-infected patients (59%) than noninfected patients (33%; P = .001). Central nervous system (CNS) involvement accounts for 41% of head and neck non-Hodgkin's lymphoma in HIV-infected patients, in contrast to only 12% of noninfected patients. High-grade lymphoma (68%) are more common than intermediate (30%) or low-grade disease (2%) in the HIV-infected population, whereas low (24%) and intermediate (60%) grades are more common than high-grade lymphoma (16%) in noninfected patients (P < .001). The large cell immunoblastic type (48%) is the most common subtype in HIV-infected patients, whereas diffuse large-cell type (32%) was most common in HIV-negative patients (P < .05). Survival is significantly poor for HIV-infected patients (P < .05). The impact of HIV infection on survival remain significant even after controlling for the effects of confounding factors.
Head and neck involvement with non-Hodgkin's lymphoma occurs in a significant number of HIV-infected patients. Our data show that the distribution and course of non-Hodgkin's lymphoma is unique in HIV-infected patients. A high level of suspicion for non-Hodgkin's lymphoma is required in all cases of head and neck lesions in patients with HIV infection to facilitate management.
非霍奇金淋巴瘤是人类免疫缺陷病毒（HIV）感染患者中第二常见的恶性肿瘤。然而，文献中关于非霍奇金淋巴瘤头颈部表现的信息有限。本文旨在描述HIV感染患者中非霍奇金淋巴瘤的头颈部表现，并将其与未感染患者的表现进行比较。
进行了一项病例对照研究，纳入了在5.5年期间到大城市三级医疗中心就诊的124例非霍奇金淋巴瘤患者。
总体而言，HIV感染情况下非霍奇金淋巴瘤的解剖分布没有改变，头颈部区域总体上最常受累（63%）。然而，在头颈部区域内，HIV感染患者的结外病变（59%）比未感染患者（33%；P = 0.001）明显更常见。中枢神经系统（CNS）受累在HIV感染患者的头颈部非霍奇金淋巴瘤中占41%，而在未感染患者中仅占12%。在HIV感染人群中，高级别淋巴瘤（68%）比中级（30%）或低级别疾病（2%）更常见，而在未感染患者中，低级别（24%）和中级（60%）比高级别淋巴瘤（16%）更常见（P < 0.001）。大细胞免疫母细胞型（48%）是HIV感染患者中最常见的亚型，而弥漫大细胞型（32%）在HIV阴性患者中最常见（P < 0.05）。HIV感染患者的生存率明显较差（P < 0.05）。即使在控制了混杂因素的影响后，HIV感染对生存的影响仍然显著。
大量HIV感染患者会出现头颈部非霍奇金淋巴瘤受累。我们的数据表明，HIV感染患者中非霍奇金淋巴瘤的分布和病程是独特的。对于HIV感染患者的所有头颈部病变病例，都需要高度怀疑非霍奇金淋巴瘤，以便于管理。
