Hodgkin's disease (HD) has a higher incidence in HIV-positive individuals.
It tends to occur at extranodal sites, frequently exhibits an unfavorable h
istological type with large numbers of neoplastic cells, and almost invaria
bly harbors Epstein-Barr Virus (EBV). We describe a case of a 33-year-old H
IV-positive man who presented with anal pain from a 4-cm mass in the anorec
tal canal. He had no a symptoms or peripheral lymphadenopathy. A chest X-ra
y was within normal limits. A biopsy showed an ulcerated mass composed of a
mixed infiltrate of lymphocytes, plasma cells, eosinophils, and Reed-Stern
berg (RS) cells positive for CD15 and strongly positive for CD30. They were
negative for CD45 and CD20. Numerous RS cells and lymphocytes were positiv
e for EBV RNA using the EBER-1 probe. This highly unusual presentation of H
o may reflect the greater incidence of anorectal lymphoma and of extranodal
HD in the HIV-positive population. (C) 2001 Wiley-Liss, Inc.