João de Barros Barreto University Hospital, Department of Surgery and Oral Pathology, Mundurucus Street, no. 4487, Zip Code 66073-000, Belém, Pará, Brazil
Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e99-e105. doi: 10.4317/medoral.24993.
HIV-related non-Hodgkin lymphomas of the oral cavity are rare lesions with aggressive clinical behaviour. The aim of this study is to describe the clinicopathological features of a series of HIV-related oral non-Hodgkin lymphomas.
Eleven cases of oral lymphomas affecting HIV-positive patients were retrieved from 2012 to 2019. Clinicopathological features regarding age, sex, tumour location, clinical presentation, laboratory findings, disease stage and follow-up were obtained. Histologic, immunohistochemical and in situ hybridization for EBV detection were done for diagnosis confirmation. Overall survival was estimated by Kaplan-Meier curve.
Males predominated, with a mean age of 40.3 years-old. Maxilla and mandible were the mostly affected. Plasmablastic lymphoma and diffuse large B-cell lymphoma not otherwise specified (NOS) were the main histological types. Lesions presented as reddish ulcerated swellings, representing the first sign of AIDS in six cases. Stage IV were common (7 cases) and the mean HIV viral load was 10,557 copies/mL, with a mean of 266 CD4+ cells/mm3, 1,278 CD8+ cells/mm3 and a CD4+/CD8+ ratio of 0.26. Eight patients died of the disease (72.7%). Overall survival revealed that 78.2% of the patients died after 21 months of follow-up.
HIV-related oral lymphomas present a poor prognosis usually diagnosed in advanced stages and in our series plasmablastic lymphoma was the most common subtype.
口腔 HIV 相关非霍奇金淋巴瘤是一种具有侵袭性临床行为的罕见病变。本研究旨在描述一系列 HIV 相关口腔非霍奇金淋巴瘤的临床病理特征。
从 2012 年至 2019 年,共检索到 11 例影响 HIV 阳性患者的口腔淋巴瘤病例。获得了与年龄、性别、肿瘤部位、临床表现、实验室检查、疾病分期和随访相关的临床病理特征。为了确认诊断,进行了组织学、免疫组织化学和 EBV 原位杂交检测。通过 Kaplan-Meier 曲线估计总生存率。
男性占主导地位,平均年龄为 40.3 岁。上颌骨和下颌骨是最常受影响的部位。主要组织学类型为浆母细胞淋巴瘤和弥漫性大 B 细胞淋巴瘤非特指型。病变表现为红色溃疡性肿胀,在 6 例中代表 AIDS 的首发症状。IV 期病变常见(7 例),平均 HIV 病毒载量为 10557 拷贝/mL,平均 CD4+细胞/mm3 为 266,CD8+细胞/mm3 为 1278,CD4+/CD8+比值为 0.26。8 例患者死于该疾病(72.7%)。总生存率显示,78.2%的患者在 21 个月的随访后死亡。
HIV 相关口腔淋巴瘤预后不良,通常在晚期诊断,在我们的研究中,浆母细胞淋巴瘤是最常见的亚型。