Nganga Edward Chege, Gitau Samuel
Aga Khan University Hospital Nairobi, 3rd Parklands Avenue, Limuru Road, Nairobi, Kenya.
Insights Imaging. 2020 May 19;11(1):67. doi: 10.1186/s13244-020-00871-w.
Lymphoma in HIV-infected patients is AIDS defining. This is the second most common AIDS defining malignancy after Kaposi's sarcoma. Development of lymphoma in HIV patients is related to immunosuppression and high viral load. Co-infection with other lymphotrophic viruses especially EBV is also strongly associated with development of lymphoma in HIV patients. Despite advances in HAART therapy, incidence of diffuse large B cell lymphoma in HIV-infected patients remains significantly higher than in the general population.Early diagnosis is challenging due to presence of opportunistic infections and atypical presentation of the lymphoma in this subset of patients. Atypical imaging findings are not unusual, and the diagnosis of lymphoma on imaging is on many occasions unexpected as the patient would ideally be initially investigated for presumed opportunistic infection.Lymphoma treatment approaches in HIV patients are complicated by comorbidity with opportunistic infections and performance status of the patients. Treatment failure and early relapse are also common in AIDS-related lymphoma. This review article highlights the common and unusual multimodality imaging findings in HIV-associated lymphoma.
HIV感染患者发生的淋巴瘤属于艾滋病指征性疾病。这是继卡波西肉瘤之后第二常见的艾滋病指征性恶性肿瘤。HIV患者淋巴瘤的发生与免疫抑制及高病毒载量有关。与其他嗜淋巴细胞病毒(尤其是EB病毒)合并感染也与HIV患者淋巴瘤的发生密切相关。尽管高效抗逆转录病毒疗法(HAART)取得了进展,但HIV感染患者弥漫性大B细胞淋巴瘤的发病率仍显著高于普通人群。由于该类患者存在机会性感染且淋巴瘤表现不典型,早期诊断具有挑战性。非典型影像学表现并不罕见,而且在很多情况下,影像学诊断出淋巴瘤会出人意料,因为患者最初理想情况下会因疑似机会性感染而接受检查。HIV患者的淋巴瘤治疗方法因合并机会性感染及患者的身体状况而变得复杂。治疗失败和早期复发在艾滋病相关淋巴瘤中也很常见。这篇综述文章重点介绍了HIV相关淋巴瘤常见和不常见的多模态影像学表现。