Rl. Kerschmann et al., CUTANEOUS PRESENTATIONS OF LYMPHOMA IN HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE - PREDOMINANCE OF T-CELL LINEAGE, Archives of dermatology, 131(11), 1995, pp. 1281-1288
Background and Design: Most non-Hodgkin's lymphomas in patients with h
uman immunodeficiency virus infection are of B-cell lineage. Cutaneous
lymphoma in the human immunodeficiency virus disease has not been sys
tematically reviewed. We studied 25 patients with both human immunodef
iciency virus infection and cutaneous presentations of lymphoma, using
immunohistochemistry and in situ hybridization for Epstein-Barr virus
. Results: Two groups of patients were discerned: (1) those with condi
tions similar to mycosis fungoides or Sezary syndrome with an indolent
course (n = 8) and (2) those with nodules or papules, greater immunos
uppression, a rapid clinical course, and large cell lymphoma seen on b
iopsy specimens (n = 17). The epidermotropic lymphomas were of T-cell
lineage and CD30(-). Thirteen of the large cell lymphomas were also of
the T-cell type, and 71% were CD30(+). Epstein-Barr virus was absent
in the epidermotropic lymphomas, but it was present in 73% of the none
pidermotropic cases. Conclusions: Two forms of human immunodeficiency
virus-associated cutaneous lymphoma were found: indolent disease resem
bling mycosis fungoides or Sezary syndrome and large cell lymphomas wi
th a poor prognosis, whose cells often had a CD30(+) T-cell phenotype
and harbored the Epstein-Barr virus.