IMMUNOPHENOTYPIC AND GENOTYPIC ANALYSIS OF ACQUIRED IMMUNODEFICIENCY SYNDROME-RELATED NON-HODGKINS-LYMPHOMAS - CORRELATION WITH HISTOLOGIC FEATURES IN 36 CASES

High-grade B-cell-type non-Hodgkin's lymphomas are observed in 5% to 8 % of patients positive for the human immunodeficiency virus. Nearly al l cases belong to one of the three major histologic types: centroblast ic or large noncleaved cell, immunoblastic and Burkitt's lymphoma, or small noncleaved cell. Some cases that are polymorphic are termed high -grade B-cell, not otherwise specified (NOS). The authors determined t he immunophenotype of each histologic category of acquired immunodefic iency syndrome (AIDS)-related non-Hodgkins' lymphoma and sought a rela tionship with the presence of the Epstein-Barr virus (EBV). B-cell dif ferentiation antigens, activation marker expression (human leukocyte a ntigen-DR, CD10, CD19, CD20, CD21, CD22, CD23, CD25, CD30, CD38), and epithelial membrane antigen were analyzed. The clonality was determine d by the detection of cytoplasmic immunoglobulin, surface immunoglobul in, and the analysis of joining region (JH) immunoglobulin gene config uration by Southern blot. Epstein-Barr virus was detected either by So uthern blot analysis using BamHI W probe fragment or by in situ hybrid ization with EBV-encoded RNA transcripts-1 specific probe. The immunop henotypic and genotypic results were compared with the morphology resu lts and with the presence or absence of EBV. Burkitt's lymphomas were associated with EBV in 50% of cases, were monoclonal, and expressed mo stly immunoglobulin (Ig) MK, CD10, CD19, CD20, CD22, and CD38. This im munophenotypic profile closely resembled those of the centroblastic ca ses (large noncleaved cell), in which EBV was absent. Epstein-Barr vir us was associated with 90% of immunoblastic cases, and only CD10, CD20 , and CD38 were expressed. CD71 was expressed in all categories of non -Hodgkin's lymphoma, and CD21 and CD23 were rarely expressed. Two case s of immunoblastic lymphoma and one case of high-grade B-NOS were poly clonal regarding JH rearrangement, but EBV tested with 1.9-Kb Xhol fra gment was clonal. No significant immunophenotypic changes were noted i n relation to the presence of EBV. Such studies comparing morphology, immunophenotype, and genotype could help classify and better understan d the pathogenesis of AIDS-related non-Hodgkin's lymphoma.