Head and neck manifestations of non-Hodgkin's lymphoma in human immunodeficiency virus-infected patients

Purpose: Non-Hodgkin's lymphoma is the 2nd most common malignancy in human immunodeficiency virus (HIV)-infected patients. However, limited informatio n regarding head and neck manifestations of non-Hodgkin's lymphoma is prese nt in the literature. The aim of this article is to describe the head and n eck manifestations of non-Hodgkin's lymphoma in HIV-infected patients and c ompare it with that seen in noninfected patients. Patients and Methods: A case-control study was performed including 124 pati ents with non-Hodgkin's lymphoma presenting over a 5.5-year period to terti ary care center in a metropolitan location. Results: Overall, the anatomic distribution of non-Hodgkin's lymphoma is no t altered in the presence of HIV infection with the head and neck region (6 3%) most often involved overall. However, within the head and neck region, extralymphatic disease is significantly more common in HIV-infected patient s (59%) than noninfected patients (33%; P = .001). Central nervous system ( CNS) involvement accounts for 41% of head and neck non-Hodgkin's lymphoma i n HIV-infected patients, in contrast to only 12% of noninfected patients. H igh-grade lymphoma (68%) are more common than intermediate (30%) or low-gra de disease (2%) in the HIV-infected population, whereas low (24%) and inter mediate (60%) grades are more common than high-grade lymphoma (16%) in noni nfected patients (P < .001). The large cell immunoblastic type (48%) is the most common subtype in HIV-infected patients, whereas diffuse large-cell t ype (32%) was most common in HIV-negative patients (P < .05). Survival is s ignificantly poor for HIV-infected patients (P < .05). The impact of HIV in fection on survival remain significant even after controlling for the effec ts of confounding factors. Conclusions: Head and neck involvement with non-Hodgkin's lymphoma occurs i n a significant number of HIV-infected patients. Our data show that the dis tribution and course of non-Hodgkin's lymphoma is unique in HIV-infected pa tients. A high level of suspicion for non-Hodgkin's lymphoma is required in all cases of head and neck lesions in patients with HIV infection to facil itate management. (Am J Otolaryngol 2000;21:10-13. Copyright (C) 2000 by W. B. Saunders Company).