Background: Aggressive non-Hodgkin's lymphomas are common among patients in
fected with HIV: Although such lymphomas are mostly of the B-cell type, var
ious cases of cutaneous T-cell lymphoma (CTCL) have also been reported. Rec
ent reports suggest that some HIV-related lymphoproliferative conditions ma
y not be clonal processes, but polyclonal lymphoid proliferations.
Objective: We reviewed our experience with HIV patients seen at the dermato
logy clinics for possible CTCL.
Methods: A retrospective study was performed to evaluate clinical, laborato
ry, and histologic findings of HIV-infected patients with atypical T-cell c
utaneous infiltrates.
Results: We observed 9 patients with advanced HN infection and a cutaneous
eruption characterized by a dense infiltrate of lymphocytes resembling myco
sis fungoides histopathologically: but composed of CD8(+) cells. Although c
lonality was not identified in any of the 6 cases tested, 3 patients had si
milar CD8(+) infiltrates involving lymph nodes or bone marrow Of the 9 pati
ents, 8 died of AIDS wasting syndrome or infections in less than 1 year.
Conclusion: Cutaneous and systemic infiltrates with polyclonal CD8 T lympho
cytes can be seen in patients with advanced HIV infection and profound CD4
lymphopenia. The clinical presentation may resemble CTCL and is associated
with a poor outcome.