Ioachim H L, Cooper M C, Hellman G C
Department of Pathology, Lenox Hill Hospital, New York, NY 10021.
Cancer Detect Prev Suppl. 1987;1:557-65.
An increased incidence of lymphoid neoplasias is associated with the states of immune deficiency both congenital and acquired. Thirty-five cases of lymphoma in males at high risk for AIDS were diagnosed in one community hospital in New York City within the past 2 years. The mean age of these patients was 39.6 years; 34 were homosexual, and one was an intravenous drug abuser. There were four Hodgkin and 31 non-Hodgkin lymphomas of various histologic types but almost all of high-grade categories. The proportion of extranodal lymphomas, the involvement of the gastrointestinal tract, central nervous system, bone marrow, and myocardium were significantly higher than in the lymphomas of the general population. The phenotypes were B-cell and non-B-non-T-cell types without any T-cell lymphomas. All patients had reversed helper-suppressor T-cell ratios, and all those tested had circulating HTLV-III and antilymphocyte antibodies. Nine patients have had previous lymph node biopsies showing the lesions of AIDS-related lymphadenopathies that were often directly associated with lymphoma. A variety of severe opportunistic infections and Kaposi sarcoma affected these patients. All lymphomas associated with immune deficiency were highly aggressive, involved multiple organs, and responded poorly to treatment resulting in early deaths.
淋巴组织肿瘤发病率的增加与先天性和后天性免疫缺陷状态相关。在过去两年中，纽约市的一家社区医院诊断出35例艾滋病高危男性淋巴瘤患者。这些患者的平均年龄为39.6岁；其中34例为同性恋者，1例为静脉吸毒者。有4例霍奇金淋巴瘤和31例不同组织学类型的非霍奇金淋巴瘤，但几乎所有都属于高级别类别。结外淋巴瘤的比例、胃肠道、中枢神经系统、骨髓和心肌的受累情况均显著高于普通人群的淋巴瘤。其表型为B细胞和非B非T细胞类型，无T细胞淋巴瘤。所有患者的辅助性T细胞与抑制性T细胞比例均倒置，所有检测患者均有循环HTLV-III和抗淋巴细胞抗体。9例患者既往有淋巴结活检显示与艾滋病相关淋巴结病的病变，这些病变常与淋巴瘤直接相关。多种严重的机会性感染和卡波西肉瘤影响了这些患者。所有与免疫缺陷相关的淋巴瘤都具有高度侵袭性，累及多个器官，对治疗反应不佳，导致早期死亡。
