EBV-associated perianal Hodgkin's disease in an HIV-positive individual

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.