CD30 (KI-1) POSITIVE ANAPLASTIC LARGE-CELL LYMPHOMAS IN INDIVIDUALS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

Background. CD30 (Ki-1) positive anaplastic large cell lymphoma (ALCL) has been only rarely described in HIV-positive patients. Methods. The clinicopathologic features of eight ALCLs occurring in four AIDS and four HIV-positive patients were investigated. The phenotype of each ne oplasm was determined by immunohistochemical methods. In three cases f resh tissue was available for molecular analysis. Results. The ALCLs a re a clinically heterogeneous group of T (4), B (1) and indeterminate (3) cell malignant lymphomas which presented in the skin (4), liver (1 ), lung (1), nasal cavity (1; also with bone marrow involvement) and p eritoneal fluid (1). While most of the patients had aggressive disease , dying in a median of three months, two patients had either localized or regressing skin lesions. Molecular studies showed that two ALCLs, one of B cell and one of indeterminate cell lineage, contained clonal Epstein-Barr virus sequences. None of the ALCLs examined contained evi dence of HTLV-1 or HIV integration nor did they exhibit c-myc or bcl-2 proto-oncogene rearrangements. No mutations or deletions of the p53 t umor suppressor gene were identified in the three cases studied. Concl usions. HIV-related ALCL represents a clinically heterogeneous group o f T cell, B cell and null cell malignant lymphomas, distinct from the previously described categories of AIDS-associated NHL, that may expan d the spectrum of lymphoid neoplasms associated with HIV-infection. Id entification and investigation of other cases of HIV-associated ALCL i s important to determine the nature of the relationship between HIV in fection and the development of ALCL.