HODGKINS-DISEASE AND NON-HODGKINS-LYMPHOMA IN AN HIV-POSITIVE PATIENT

The occurrence of HIV associated non-Hodgkin's lymphoma (NHL) is a wel l recognized event. HIV associated Hodgkin's disease (HD) has also bee n observed. A unique patient with both entities is described. The pati ent was a 29 year old homosexual male who developed clinical IIA nodul ar sclerosis HD in 1985. He was HIV + with CD4/CD8 = 0.2 and his siste r had HD 20 years earlier. He received MOPP and had a complete respons e. In October 1988 he developed weight loss with an abdominal mass and biopsy revealed diffuse small non-cleaved NHL, with bone marrow invol vement. This was his first AIDS associated illness. Probes identified clonally rearranged DNA fragments in the J region of IgH chains and cl onal rearrangements in the c-myc gene were also observed but EBV seque nces could not be demonstrated. He was treated with m-BACOD but died i n March 1989. His course was not complicated by opportunistic infectio n. Possible etiologies for the HD include his HIV status or shared sib ling environment. The development of the NHL may have resulted from HI V infection and/or secondary to his treatment for HD. The relationship between the two lymphomas is uncertain and factors other than HIV exp osure and its immune dysfunction may have been causal.