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[[Diffuse large B-cell lymphoma]] is a highly aggressive type of [[B-cell lymphoma]]. It is distinguished by the widespread proliferation of large neoplastic [[B cell|B lymphocytes]] with nuclei that are equal to or larger than normal histiocytic nuclei.<ref name="Classification of Diffuse Large B-cell Lymphomas">{{cite journal | last=Xie | first=Yi | last2=Pittaluga | first2=Stefania | last3=Jaffe | first3=Elaine S. | title=The Histological Classification of Diffuse Large B-cell Lymphomas | journal=Seminars in Hematology | publisher=Elsevier BV | volume=52 | issue=2 | year=2015 | issn=0037-1963 | doi=10.1053/j.seminhematol.2015.01.006 | pages=57–66}}</ref> The illness manifests with B symptoms at an advanced stage of the illness. It mostly affects patients who are severely immunosuppressed and can occur at nodal or extranodal sites, with the [[gastrointestinal tract]] being the most common site.<ref name="EPIDEMIOLOGY TO CLINICAL MANAGEMENT">{{cite journal | last=Re | first=Alessandro | last2=Cattaneo | first2=Chiara | last3=Rossi | first3=Giuseppe | title=HIV AND LYMPHOMA: FROM EPIDEMIOLOGY TO CLINICAL MANAGEMENT | journal=Mediterranean Journal of Hematology and Infectious Diseases | publisher=Institute of Hematology, Catholic University | volume=11 | issue=1 | date=January 1, 2019 | issn=2035-3006 | doi=10.4084/mjhid.2019.004 | page=}}</ref><ref name="Magangane Mohamed Naidoo 2020 p. ">{{cite journal | last=Magangane | first=Pumza S. | last2=Mohamed | first2=Zainab | last3=Naidoo | first3=Richard | title=Diffuse large B-cell lymphoma in a high human immunodeficiency virus (HIV) prevalence, low-resource setting | journal=South African Journal of Oncology | publisher=AOSIS | volume=4 | date=February 24, 2020 | issn=2518-8704 | doi=10.4102/sajo.v4i0.104 | page=}}</ref> It makes up between 45 and 50 percent of all [[Lymphoma|lymphomas]] seen in this group, making it the most prevalent AIDS-associated lymphoma subtype.<ref name="Wu Chen Zhang Li 2019 p. ">{{cite journal | last=Wu | first=Dedong | last2=Chen | first2=Chen | last3=Zhang | first3=Mingzhi | last4=Li | first4=Zhaoming | last5=Wang | first5=Suqian | last6=Shi | first6=Jijing | last7=Zhang | first7=Yu | last8=Yao | first8=Dingzhu | last9=Hu | first9=Shuang | title=The clinical features and prognosis of 100 AIDS-related lymphoma cases | journal=Scientific Reports | publisher=Springer Science and Business Media LLC | volume=9 | issue=1 | date=March 29, 2019 | issn=2045-2322 | doi=10.1038/s41598-019-41869-9 | page=}}</ref><ref name="Meister Hentrich Wyen Hübel 2018 pp. 119–126">{{cite journal | last=Meister | first=Anne | last2=Hentrich | first2=Marcus | last3=Wyen | first3=Christoph | last4=Hübel | first4=Kai | title=Malignant lymphoma in the <scp>HIV</scp>‐positive patient | journal=European Journal of Haematology | publisher=Wiley | volume=101 | issue=1 | date=May 22, 2018 | issn=0902-4441 | doi=10.1111/ejh.13082 | pages=119–126}}</ref> All ages are affected by DLBCL, which typically manifests as a rapidly growing [[lymph node]] mass in the neck or abdomen.<ref name="HIV/AIDS Associated Lymphoma">{{cite journal | last=Berhan | first=Ayenew | last2=Bayleyegn | first2=Biruk | last3=Getaneh | first3=Zegeye | title=HIV/AIDS Associated Lymphoma: Review | journal=Blood and Lymphatic Cancer: Targets and Therapy | publisher=Informa UK Limited | volume=12 | year=2022 | issn=1179-9889 | doi=10.2147/blctt.s361320 | doi-access=free | pages=31–45}}</ref> Up to 40% of patients have extranodal extramedullary disease, and about 30% of patients exhibit B symptoms.<ref name="Shah Keraliya Jagannathan Tirumani 2017 p. 54">{{cite journal | last=Shah | first=Hina J. | last2=Keraliya | first2=Abhishek R. | last3=Jagannathan | first3=Jyothi P. | last4=Tirumani | first4=Sree Harsha | last5=Lele | first5=Vikram R. | last6=DiPiro | first6=Pamela J. | title=Diffuse Large B-Cell Lymphoma in the Era of Precision Oncology: How Imaging Is Helpful | journal=Korean Journal of Radiology | publisher=The Korean Society of Radiology | volume=18 | issue=1 | year=2017 | issn=1229-6929 | doi=10.3348/kjr.2017.18.1.54 | page=54}}</ref>
[[Diffuse large B-cell lymphoma]] is a highly aggressive type of [[B-cell lymphoma]]. It is distinguished by the widespread proliferation of large neoplastic [[B cell|B lymphocytes]] with nuclei that are equal to or larger than normal histiocytic nuclei.<ref name="Classification of Diffuse Large B-cell Lymphomas">{{cite journal | last=Xie | first=Yi | last2=Pittaluga | first2=Stefania | last3=Jaffe | first3=Elaine S. | title=The Histological Classification of Diffuse Large B-cell Lymphomas | journal=Seminars in Hematology | publisher=Elsevier BV | volume=52 | issue=2 | year=2015 | issn=0037-1963 | doi=10.1053/j.seminhematol.2015.01.006 | pages=57–66}}</ref> The illness manifests with B symptoms at an advanced stage of the illness. It mostly affects patients who are severely immunosuppressed and can occur at nodal or extranodal sites, with the [[gastrointestinal tract]] being the most common site.<ref name="EPIDEMIOLOGY TO CLINICAL MANAGEMENT">{{cite journal | last=Re | first=Alessandro | last2=Cattaneo | first2=Chiara | last3=Rossi | first3=Giuseppe | title=HIV AND LYMPHOMA: FROM EPIDEMIOLOGY TO CLINICAL MANAGEMENT | journal=Mediterranean Journal of Hematology and Infectious Diseases | publisher=Institute of Hematology, Catholic University | volume=11 | issue=1 | date=January 1, 2019 | issn=2035-3006 | doi=10.4084/mjhid.2019.004 | page=}}</ref><ref name="Magangane Mohamed Naidoo 2020 p. ">{{cite journal | last=Magangane | first=Pumza S. | last2=Mohamed | first2=Zainab | last3=Naidoo | first3=Richard | title=Diffuse large B-cell lymphoma in a high human immunodeficiency virus (HIV) prevalence, low-resource setting | journal=South African Journal of Oncology | publisher=AOSIS | volume=4 | date=February 24, 2020 | issn=2518-8704 | doi=10.4102/sajo.v4i0.104 | page=}}</ref> It makes up between 45 and 50 percent of all [[Lymphoma|lymphomas]] seen in this group, making it the most prevalent AIDS-associated lymphoma subtype.<ref name="Wu Chen Zhang Li 2019 p. ">{{cite journal | last=Wu | first=Dedong | last2=Chen | first2=Chen | last3=Zhang | first3=Mingzhi | last4=Li | first4=Zhaoming | last5=Wang | first5=Suqian | last6=Shi | first6=Jijing | last7=Zhang | first7=Yu | last8=Yao | first8=Dingzhu | last9=Hu | first9=Shuang | title=The clinical features and prognosis of 100 AIDS-related lymphoma cases | journal=Scientific Reports | publisher=Springer Science and Business Media LLC | volume=9 | issue=1 | date=March 29, 2019 | issn=2045-2322 | doi=10.1038/s41598-019-41869-9 | page=}}</ref><ref name="Meister Hentrich Wyen Hübel 2018 pp. 119–126">{{cite journal | last=Meister | first=Anne | last2=Hentrich | first2=Marcus | last3=Wyen | first3=Christoph | last4=Hübel | first4=Kai | title=Malignant lymphoma in the <scp>HIV</scp>‐positive patient | journal=European Journal of Haematology | publisher=Wiley | volume=101 | issue=1 | date=May 22, 2018 | issn=0902-4441 | doi=10.1111/ejh.13082 | pages=119–126}}</ref> All ages are affected by DLBCL, which typically manifests as a rapidly growing [[lymph node]] mass in the neck or abdomen.<ref name="HIV/AIDS Associated Lymphoma">{{cite journal | last=Berhan | first=Ayenew | last2=Bayleyegn | first2=Biruk | last3=Getaneh | first3=Zegeye | title=HIV/AIDS Associated Lymphoma: Review | journal=Blood and Lymphatic Cancer: Targets and Therapy | publisher=Informa UK Limited | volume=12 | year=2022 | issn=1179-9889 | doi=10.2147/blctt.s361320 | doi-access=free | pages=31–45}}</ref> Up to 40% of patients have extranodal extramedullary disease, and about 30% of patients exhibit B symptoms.<ref name="Shah Keraliya Jagannathan Tirumani 2017 p. 54">{{cite journal | last=Shah | first=Hina J. | last2=Keraliya | first2=Abhishek R. | last3=Jagannathan | first3=Jyothi P. | last4=Tirumani | first4=Sree Harsha | last5=Lele | first5=Vikram R. | last6=DiPiro | first6=Pamela J. | title=Diffuse Large B-Cell Lymphoma in the Era of Precision Oncology: How Imaging Is Helpful | journal=Korean Journal of Radiology | publisher=The Korean Society of Radiology | volume=18 | issue=1 | year=2017 | issn=1229-6929 | doi=10.3348/kjr.2017.18.1.54 | page=54}}</ref>


The second most prevalent NHL subtype that affects HIV-positive individuals with a comparatively high CD4 cell count is Burkitt's lymphoma. Patients typically have elevated lactate dehydrogenase levels and poor performance status.<ref name="HIV/AIDS Associated Lymphoma" /> The central nervous system is involved in 8 to 28% of cases, with extranodal involvement occurring more frequently.<ref name="EPIDEMIOLOGY TO CLINICAL MANAGEMENT" /> It usually manifests at a younger age and with CD4 cell counts greater than 200 cells/μL.<ref name="JCDR Research and Publications 2013 p. ">{{cite journal | title=HIV Associated Intra–oral Burkitt’s Lymphoma: A Case Report | journal=JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH | publisher=JCDR Research and Publications | year=2013 | issn=2249-782X | doi=10.7860/jcdr/2013/6715.3862 | page=}}</ref> It develops quickly and is a kind of tumor that starts from B cells. In addition, it is fatal if untreated.<ref name="Ansorge 2021 l147">{{cite web | last=Ansorge | first=Rick | title=Burkitt Lymphoma: Diagnosis, Prognosis, Symptoms, and Treatments | website=WebMD | date=November 1, 2021 | url=https://www.webmd.com/cancer/lymphoma/burkitt-lymphoma-prognosis-diagnosis-treatments#1 | access-date=February 11, 2024}}</ref> Burkitt's lymphoma is linked to a high incidence of oral cavity involvement and makes up 10-15% of AIDS-defining lymphomas.<ref name="HIV/AIDS Associated Lymphoma" /> Three clinical subtypes of Burkitt's lymphoma have been identified: endemic, sporadic, and immunodeficiency-related.<ref name="Dozzo Carobolante Donisi Scattolin 2016 pp. 11–29">{{cite journal | last=Dozzo | first=Massimo | last2=Carobolante | first2=Francesca | last3=Donisi | first3=Pietro Maria | last4=Scattolin | first4=Annamaria | last5=Maino | first5=Elena | last6=Sancetta | first6=Rosaria | last7=Viero | first7=Piera | last8=Bassan | first8=Renato | title=Burkitt lymphoma in adolescents and young adults: management challenges | journal=Adolescent Health, Medicine and Therapeutics | publisher=Informa UK Limited | volume= 8 | year=2016 | issn=1179-318X | doi=10.2147/ahmt.s94170 | doi-access=free | pages=11–29}}</ref> Thirty to forty percent of AIDS-related NHL cases are Burkitt's lymphoma subtype, which is most prevalent in HIV/AIDS patients.<ref name="Ansorge 2021 l147"/>
The second most prevalent NHL subtype that affects HIV-positive individuals with a comparatively high [[CD4]] cell count is [[Burkitt lymphoma|Burkitt's lymphoma]]. Patients typically have elevated [[lactate dehydrogenase]] levels and poor performance status.<ref name="HIV/AIDS Associated Lymphoma" /> The [[central nervous system]] is involved in 8 to 28% of cases, with extranodal involvement occurring more frequently.<ref name="EPIDEMIOLOGY TO CLINICAL MANAGEMENT" /> It usually manifests at a younger age and with [[CD4]] cell counts greater than 200 cells/μL.<ref name="JCDR Research and Publications 2013 p. ">{{cite journal | title=HIV Associated Intra–oral Burkitt’s Lymphoma: A Case Report | journal=JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH | publisher=JCDR Research and Publications | year=2013 | issn=2249-782X | doi=10.7860/jcdr/2013/6715.3862 | page=}}</ref> It develops quickly and is a kind of tumor that starts from [[B cell|B cells]]. In addition, it is fatal if untreated.<ref name="Ansorge 2021 l147">{{cite web | last=Ansorge | first=Rick | title=Burkitt Lymphoma: Diagnosis, Prognosis, Symptoms, and Treatments | website=WebMD | date=November 1, 2021 |url=https://www.webmd.com/cancer/lymphoma/burkitt-lymphoma-prognosis-diagnosis-treatments#1 | access-date=February 11, 2024}}</ref> [[Burkitt lymphoma|Burkitt's lymphoma]] is linked to a high incidence of oral cavity involvement and makes up 10-15% of AIDS-defining lymphomas.<ref name="HIV/AIDS Associated Lymphoma" /> Three clinical subtypes of [[Burkitt lymphoma|Burkitt's lymphoma]] have been identified: endemic, sporadic, and [[immunodeficiency]]-related.<ref name="Dozzo Carobolante Donisi Scattolin 2016 pp. 11–29">{{cite journal | last=Dozzo | first=Massimo | last2=Carobolante | first2=Francesca | last3=Donisi | first3=Pietro Maria | last4=Scattolin | first4=Annamaria | last5=Maino | first5=Elena | last6=Sancetta | first6=Rosaria | last7=Viero | first7=Piera | last8=Bassan | first8=Renato | title=Burkitt lymphoma in adolescents and young adults: management challenges | journal=Adolescent Health, Medicine and Therapeutics | publisher=Informa UK Limited | volume= 8 | year=2016 | issn=1179-318X | doi=10.2147/ahmt.s94170 | doi-access=free | pages=11–29}}</ref> Thirty to forty percent of AIDS-related NHL cases are [[Burkitt lymphoma|Burkitt's lymphoma]] subtype, which is most prevalent in [[HIV/AIDS]] patients.<ref name="Ansorge 2021 l147"/>


Primary central nervous system lymphoma (PCNSL) is a subtype of NHL that impacts the eyes, brain, spine, and cerebrospinal fluid in the central nervous system.<ref name="Grommes DeAngelis 2017 pp. 2410–2418">{{cite journal | last=Grommes | first=Christian | last2=DeAngelis | first2=Lisa M. | title=Primary CNS Lymphoma | journal=Journal of Clinical Oncology | publisher=American Society of Clinical Oncology (ASCO) | volume=35 | issue=21 | date=July 20, 2017 | issn=0732-183X | doi=10.1200/jco.2017.72.7602 | pages=2410–2418}}</ref> It appears in patients who have severe immune suppression; since the advent of highly active antiretroviral therapy, its incidence has declined in these patients. The majority of PCNSL linked to HIV is Epstein-Barr virus positive.<ref name="HIV/AIDS Associated Lymphoma" /> Furthermore, unlike HIV-negative PCNSL, patients typically present with multiple brain lesions and/or changes in mental status or focal neurologic symptoms.<ref name="Meister Hentrich Wyen Hübel 2018 pp. 119–126" /><ref name="Dunleavy Wilson 2012 pp. 3245–3255">{{cite journal | last=Dunleavy | first=Kieron | last2=Wilson | first2=Wyndham H. | title=How I treat HIV-associated lymphoma | journal=Blood | publisher=American Society of Hematology | volume=119 | issue=14 | date=April 5, 2012 | issn=0006-4971 | doi=10.1182/blood-2011-08-373738 | pages=3245–3255}}</ref> Changes in mental state, intracranial pressure symptoms (headache, nausea, vomiting, papilledema), and local compression symptoms (epilepsy, memory loss, unstable gait, visual impairment, blurred speech) are the most common symptoms of PCNSL.<ref name="Zhao Ma Zhang Zheng 2019 p. ">{{cite journal | last=Zhao | first=Hui | last2=Ma | first2=Miao | last3=Zhang | first3=Limin | last4=Zheng | first4=Guanghui | last5=Lv | first5=Hong | last6=Liu | first6=Jie | last7=Li | first7=Xiao | last8=Song | first8=Bei | last9=Zhang | first9=Guojun | title=Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report | journal=BMC Neurology | publisher=Springer Science and Business Media LLC | volume=19 | issue=1 | date=May 7, 2019 | issn=1471-2377 | doi=10.1186/s12883-019-1317-3 | doi-access=free | page=}}</ref>
[[Primary central nervous system lymphoma]] (PCNSL) is a subtype of NHL that impacts the eyes, brain, spine, and [[cerebrospinal fluid]] in the [[central nervous system]].<ref name="Grommes DeAngelis 2017 pp. 2410–2418">{{cite journal | last=Grommes | first=Christian | last2=DeAngelis | first2=Lisa M. | title=Primary CNS Lymphoma | journal=Journal of Clinical Oncology | publisher=American Society of Clinical Oncology (ASCO) | volume=35 | issue=21 | date=July 20, 2017 | issn=0732-183X | doi=10.1200/jco.2017.72.7602 | pages=2410–2418}}</ref> It appears in patients who have severe immune suppression; since the advent of [[highly active antiretroviral therapy]], its incidence has declined in these patients. The majority of PCNSL linked to HIV is [[Epstein–Barr virus|Epstein-Barr virus]] positive.<ref name="HIV/AIDS Associated Lymphoma" /> Furthermore, unlike HIV-negative PCNSL, patients typically present with multiple brain lesions and/or changes in mental status or focal neurologic symptoms.<ref name="Meister Hentrich Wyen Hübel 2018 pp. 119–126" /><ref name="Dunleavy Wilson 2012 pp. 3245–3255">{{cite journal | last=Dunleavy | first=Kieron | last2=Wilson | first2=Wyndham H. | title=How I treat HIV-associated lymphoma | journal=Blood | publisher=American Society of Hematology | volume=119 | issue=14 | date=April 5, 2012 | issn=0006-4971 | doi=10.1182/blood-2011-08-373738 | pages=3245–3255}}</ref> Changes in mental state, [[intracranial pressure]] symptoms ([[headache]], [[nausea]], [[vomiting]], [[papilledema]]), and local compression symptoms ([[epilepsy]], [[memory loss]], unstable gait, [[visual impairment]], slurred speech) are the most common symptoms of PCNSL.<ref name="Zhao Ma Zhang Zheng 2019 p. ">{{cite journal | last=Zhao | first=Hui | last2=Ma | first2=Miao | last3=Zhang | first3=Limin | last4=Zheng | first4=Guanghui | last5=Lv | first5=Hong | last6=Liu | first6=Jie | last7=Li | first7=Xiao | last8=Song | first8=Bei | last9=Zhang | first9=Guojun | title=Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report | journal=BMC Neurology | publisher=Springer Science and Business Media LLC | volume=19 | issue=1 | date=May 7, 2019 | issn=1471-2377 | doi=10.1186/s12883-019-1317-3 | doi-access=free | page=}}</ref>


Primary effusion lymphoma is a distinct subtype of aggressive B-cell NHL. It is brought on by HHV8, commonly referred to as KSHV, or Kaposi sarcoma-associated herpesvirus.<ref name="Jarrett 2005 pp. 176–186">{{cite journal | last=Jarrett | first=Ruth F | title=Viruses and lymphoma/leukaemia | journal=The Journal of Pathology | publisher=Wiley | volume=208 | issue=2 | date=December 17, 2005 | issn=0022-3417 | doi=10.1002/path.1905 | pages=176–186}}</ref><ref name="Antar El Hajj Jabbour Khalifeh 2014 pp. e190–e190">{{cite journal | last=Antar | first=A | last2=El Hajj | first2=H | last3=Jabbour | first3=M | last4=Khalifeh | first4=I | last5=EL-Merhi | first5=F | last6=Mahfouz | first6=R | last7=Bazarbachi | first7=A | title=Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature | journal=Blood Cancer Journal | publisher=Springer Science and Business Media LLC | volume=4 | issue=3 | date=March 7, 2014 | issn=2044-5385 | doi=10.1038/bcj.2014.6 | pages=e190–e190}}</ref> It is uncommon, making up 0.3% of NHL in the general population and 4% of NHL linked to HIV. Between 60 and 90 percent of cases of primary effusion lymphoma have EBV co-infection, although its pathogenesis is unknown.<ref name="HIV/AIDS Associated Lymphoma" /> There are malignant lymphomatous effusions in the pericardium, peritoneal cavity, and pleural space.<ref name="Narkhede Arora Ujjani 2018 pp. 3747–3754">{{cite journal | last=Narkhede | first=Mayur | last2=Arora | first2=Shagun | last3=Ujjani | first3=Chaitra | title=Primary effusion lymphoma: current perspectives | journal=OncoTargets and Therapy | publisher=Informa UK Limited | volume= 11 | year=2018 | issn=1178-6930 | doi=10.2147/ott.s167392 | doi-access=free | pages=3747–3754}}</ref>
[[Primary effusion lymphoma]] is a distinct subtype of aggressive [[B cell|B-cell]] NHL. It is brought on by [[HHV8]], commonly referred to as KSHV, or [[Kaposi's sarcoma-associated herpesvirus|Kaposi sarcoma-associated herpesvirus]].<ref name="Jarrett 2005 pp. 176–186">{{cite journal | last=Jarrett | first=Ruth F | title=Viruses and lymphoma/leukaemia | journal=The Journal of Pathology | publisher=Wiley | volume=208 | issue=2 | date=December 17, 2005 | issn=0022-3417 | doi=10.1002/path.1905 | pages=176–186}}</ref><ref name="Antar El Hajj Jabbour Khalifeh 2014 pp. e190–e190">{{cite journal | last=Antar | first=A | last2=El Hajj | first2=H | last3=Jabbour | first3=M | last4=Khalifeh | first4=I | last5=EL-Merhi | first5=F | last6=Mahfouz | first6=R | last7=Bazarbachi | first7=A | title=Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature | journal=Blood Cancer Journal | publisher=Springer Science and Business Media LLC | volume=4 | issue=3 | date=March 7, 2014 | issn=2044-5385 | doi=10.1038/bcj.2014.6 | pages=e190–e190}}</ref> It is uncommon, making up 0.3% of NHL in the general population and 4% of NHL linked to [[HIV]]. Between 60 and 90 percent of cases of [[primary effusion lymphoma]] have [[Epstein–Barr virus|EBV]] co-infection, although its pathogenesis is unknown.<ref name="HIV/AIDS Associated Lymphoma" /> There are malignant lymphomatous effusions in the [[pericardium]], [[peritoneal cavity]], and [[Pleural cavity|pleural space]].<ref name="Narkhede Arora Ujjani 2018 pp. 3747–3754">{{cite journal | last=Narkhede | first=Mayur | last2=Arora | first2=Shagun | last3=Ujjani | first3=Chaitra | title=Primary effusion lymphoma: current perspectives | journal=OncoTargets and Therapy | publisher=Informa UK Limited | volume= 11 | year=2018 | issn=1178-6930 | doi=10.2147/ott.s167392 | doi-access=free | pages=3747–3754}}</ref>

[[Plasmablastic lymphoma]] (PBL) originates from terminally differentiated, activated [[B cell|B-cells]] at the post-germinal center that are changing from immunoblasts to [[Plasma cell|plasma cells]].<ref name="HIV/AIDS Associated Lymphoma" /> About 2% of all AIDS-associated lymphomas are PBL-associated lymphomas.<ref name="Castillo Bibas Miranda 2015 pp. 2323–2330">{{cite journal | last=Castillo | first=Jorge J. | last2=Bibas | first2=Michele | last3=Miranda | first3=Roberto N. | title=The biology and treatment of plasmablastic lymphoma | journal=Blood | publisher=American Society of Hematology | volume=125 | issue=15 | date=April 9, 2015 | issn=0006-4971 | doi=10.1182/blood-2014-10-567479 | pages=2323–2330}}</ref> [[HIV]] infection is closely associated with this uncommon form of [[lymphoma]], which primarily affects the oral cavity.<ref name="Elyamany Al Mussaed Alzahrani 2015 pp. 1–11">{{cite journal | last=Elyamany | first=Ghaleb | last2=Al Mussaed | first2=Eman | last3=Alzahrani | first3=Ali Matar | title=Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions | journal=Advances in Hematology | publisher=Hindawi Limited | volume=2015 | year=2015 | issn=1687-9104 | doi=10.1155/2015/315289 | doi-access=free | pages=1–11}}</ref> With a widespread proliferation of massive [[Neoplasm|neoplastic cells]] that resemble [[B cell|B-cell]] immunoblasts but have the immunophenotype of [[Plasma cell|plasma cells]], it is incredibly aggressive.<ref name="Broccoli Nanni Stefoni Agostinelli 2018 p. ">{{cite journal | last=Broccoli | first=Alessandro | last2=Nanni | first2=Laura | last3=Stefoni | first3=Vittorio | last4=Agostinelli | first4=Claudio | last5=Argnani | first5=Lisa | last6=Cavo | first6=Michele | last7=Zinzani | first7=Pier Luigi | title=A patient with plasmablastic lymphoma achieving long-term complete remission after thalidomide-dexamethasone induction and double autologous stem cell transplantation: a case report | journal=BMC Cancer | publisher=Springer Science and Business Media LLC | volume=18 | issue=1 | date=June 8, 2018 | issn=1471-2407 | doi=10.1186/s12885-018-4561-9 | doi-access=free | page=}}</ref>

[[Hodgkin lymphoma]] (HL) is one of the most common cancers that do not indicate [[HIV/AIDS|AIDS]], and since [[highly active antiretroviral therapy]] was introduced, its incidence has increased. It is a germinal center-derived cell that produces Hodgkin Reed–Sternberg (HRS) cells.<ref name="HIV/AIDS Associated Lymphoma" /> It is more common in [[Immunodeficiency|immunocompromised]] individuals, especially those with HIV.<ref name="Ul-Haq Dalla Pria Suardi Pinato 2018 p. ">{{cite journal | last=Ul-Haq | first=Ikram | last2=Dalla Pria | first2=Alessia | last3=Suardi | first3=Elisa | last4=Pinato | first4=David J. | last5=Froeling | first5=Fieke | last6=Forni | first6=John | last7=Randell | first7=Paul | last8=Bower | first8=Mark | title=Blood Epstein–Barr virus DNA does not predict outcome in advanced HIV-associated Hodgkin lymphoma | journal=Medical Oncology | publisher=Springer Science and Business Media LLC | volume=35 | issue=4 | date=March 13, 2018 | issn=1357-0560 | doi=10.1007/s12032-018-1099-2 | page=}}</ref> Compared to mild immune compromise, the incidence of HL is lower in states of extreme [[immunodeficiency]]. It's possible that there was insufficient immunological contact between non-neoplastic inflammatory cells and HRS cells.<ref name="Grogg Miller Dogan 2006 pp. 1365–1372">{{cite journal | last=Grogg | first=K L | last2=Miller | first2=R F | last3=Dogan | first3=A | title=HIV infection and lymphoma | journal=Journal of Clinical Pathology | publisher=BMJ | volume=60 | issue=12 | date=December 20, 2006 | issn=0021-9746 | doi=10.1136/jcp.2007.051953 | pages=1365–1372}}</ref>

== Mechanism ==
[[HIV]]-positive patients have a higher incidence of malignancies for a variety of reasons. These consist of [[inflammation]], [[cytokine]] dysregulation, and persistent antigenic stimulation.<ref name="HIV/AIDS Associated Lymphoma" /> Moreover, [[Oncovirus|oncogenic viruses]] are more likely to infect [[HIV/AIDS]] patients.<ref name="Yarchoan Uldrick 2018 pp. 1029–1041">{{cite journal | last=Yarchoan | first=Robert | last2=Uldrick | first2=Thomas S. | title=HIV-Associated Cancers and Related Diseases | journal=New England Journal of Medicine | publisher=Massachusetts Medical Society | volume=378 | issue=11 | date=March 15, 2018 | issn=0028-4793 | doi=10.1056/nejmra1615896 | pages=1029–1041}}</ref> Thus, a variety of factors, such as a compromised [[immune system]], genetic changes, viral infection, and persistent [[B cell]] activation, contribute to the pathogenesis of [[HIV/AIDS]]-associated lymphoma.<ref name="HIV/AIDS Associated Lymphoma" />


== References ==
== References ==
{{Reflist}}
{{Reflist}}

== Further reading ==
* {{cite journal | last=Levine | first=Alexandra M. | title=Epidemiology, Clinical Characteristics, and Management of AIDS-Related Lymphoma | journal=Hematology/Oncology Clinics of North America | publisher=Elsevier BV | volume=5 | issue=2 | year=1991 | issn=0889-8588 | doi=10.1016/s0889-8588(18)30445-3 | pages=331–342 | ref=none}}
* {{cite journal | last=Cesarman | first=Ethel | title=Pathology of lymphoma in HIV | journal=Current Opinion in Oncology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=25 | issue=5 | year=2013 | issn=1040-8746 | doi=10.1097/01.cco.0000432525.70099.a4 | pages=487–494 | ref=none}}


== External links ==
== External links ==
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* [http://oham.cancer.gov/ Office of HIV and AIDS Malignancy in the National Cancer Institute] {{Webarchive|url=https://web.archive.org/web/20170227215602/https://oham.cancer.gov/ |date=2017-02-27 }}
* [http://oham.cancer.gov/ Office of HIV and AIDS Malignancy in the National Cancer Institute] {{Webarchive|url=https://web.archive.org/web/20170227215602/https://oham.cancer.gov/ |date=2017-02-27 }}
* [https://web.archive.org/web/20090509125939/http://www.cancer.gov/cancertopics/types/AIDS/ Information on AIDS-related cancers from the National Cancer Institute]
* [https://web.archive.org/web/20090509125939/http://www.cancer.gov/cancertopics/types/AIDS/ Information on AIDS-related cancers from the National Cancer Institute]

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{{Hematological malignancy histology}}
{{Hematological malignancy histology}}

Revision as of 17:30, 11 February 2024

AIDS-related lymphoma
SpecialtyHematology and oncology

AIDS-related lymphoma describes lymphomas occurring in patients with acquired immunodeficiency syndrome (AIDS).[1][2]

A lymphoma is a type of cancer arising from lymphoid cells. In AIDS, the incidence of non-Hodgkin's lymphoma, primary cerebral lymphoma and Hodgkin's disease are all increased. There are three different varieties of AIDS-related lymphoma: Diffuse large B-cell lymphoma, B-cell immunoblastic lymphoma, and Burkitt's lymphoma (small non-cleaved cell lymphoma).[3]

Signs and symptoms

The histologic classification of the lymphoma, as well as the locations and severity of the disease, all influence the clinical presentation of HIV-related lymphomas.[4] HIV-related lymphomas are more likely to present with advanced stage disease, constitutional symptoms (also known as "B" symptoms; fever, weight loss, and night sweats), extranodal involvement, or disease involving unusual locations (such as the body cavity or soft tissue) than lymphomas in the HIV-negative population.[5][6]

HIV-related lymphomas can present with a variety of clinical symptoms, including organomegaly, lymphadenopathy, and/or constitutional symptoms. Unknown fever, cytopenias, tumor lysis syndrome (including lactic acidosis, hyperkalemia, hyperuricemia, hypocalcemia, hyperphosphatemia, and elevated lactate dehydrogenase), and other isolated laboratory abnormalities (such as hypercalcemia) are observed in certain patients.[7]

Causes

HIV-positive individuals' lymphomas vary widely and can be classified into several histologic subtypes.[8] The two primary lymphoma types that develop in HIV-positive individuals are non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL).[9]

Diffuse large B-cell lymphoma is a highly aggressive type of B-cell lymphoma. It is distinguished by the widespread proliferation of large neoplastic B lymphocytes with nuclei that are equal to or larger than normal histiocytic nuclei.[10] The illness manifests with B symptoms at an advanced stage of the illness. It mostly affects patients who are severely immunosuppressed and can occur at nodal or extranodal sites, with the gastrointestinal tract being the most common site.[11][12] It makes up between 45 and 50 percent of all lymphomas seen in this group, making it the most prevalent AIDS-associated lymphoma subtype.[13][14] All ages are affected by DLBCL, which typically manifests as a rapidly growing lymph node mass in the neck or abdomen.[15] Up to 40% of patients have extranodal extramedullary disease, and about 30% of patients exhibit B symptoms.[16]

The second most prevalent NHL subtype that affects HIV-positive individuals with a comparatively high CD4 cell count is Burkitt's lymphoma. Patients typically have elevated lactate dehydrogenase levels and poor performance status.[15] The central nervous system is involved in 8 to 28% of cases, with extranodal involvement occurring more frequently.[11] It usually manifests at a younger age and with CD4 cell counts greater than 200 cells/μL.[17] It develops quickly and is a kind of tumor that starts from B cells. In addition, it is fatal if untreated.[18] Burkitt's lymphoma is linked to a high incidence of oral cavity involvement and makes up 10-15% of AIDS-defining lymphomas.[15] Three clinical subtypes of Burkitt's lymphoma have been identified: endemic, sporadic, and immunodeficiency-related.[19] Thirty to forty percent of AIDS-related NHL cases are Burkitt's lymphoma subtype, which is most prevalent in HIV/AIDS patients.[18]

Primary central nervous system lymphoma (PCNSL) is a subtype of NHL that impacts the eyes, brain, spine, and cerebrospinal fluid in the central nervous system.[20] It appears in patients who have severe immune suppression; since the advent of highly active antiretroviral therapy, its incidence has declined in these patients. The majority of PCNSL linked to HIV is Epstein-Barr virus positive.[15] Furthermore, unlike HIV-negative PCNSL, patients typically present with multiple brain lesions and/or changes in mental status or focal neurologic symptoms.[14][21] Changes in mental state, intracranial pressure symptoms (headache, nausea, vomiting, papilledema), and local compression symptoms (epilepsy, memory loss, unstable gait, visual impairment, slurred speech) are the most common symptoms of PCNSL.[22]

Primary effusion lymphoma is a distinct subtype of aggressive B-cell NHL. It is brought on by HHV8, commonly referred to as KSHV, or Kaposi sarcoma-associated herpesvirus.[23][24] It is uncommon, making up 0.3% of NHL in the general population and 4% of NHL linked to HIV. Between 60 and 90 percent of cases of primary effusion lymphoma have EBV co-infection, although its pathogenesis is unknown.[15] There are malignant lymphomatous effusions in the pericardium, peritoneal cavity, and pleural space.[25]

Plasmablastic lymphoma (PBL) originates from terminally differentiated, activated B-cells at the post-germinal center that are changing from immunoblasts to plasma cells.[15] About 2% of all AIDS-associated lymphomas are PBL-associated lymphomas.[26] HIV infection is closely associated with this uncommon form of lymphoma, which primarily affects the oral cavity.[27] With a widespread proliferation of massive neoplastic cells that resemble B-cell immunoblasts but have the immunophenotype of plasma cells, it is incredibly aggressive.[28]

Hodgkin lymphoma (HL) is one of the most common cancers that do not indicate AIDS, and since highly active antiretroviral therapy was introduced, its incidence has increased. It is a germinal center-derived cell that produces Hodgkin Reed–Sternberg (HRS) cells.[15] It is more common in immunocompromised individuals, especially those with HIV.[29] Compared to mild immune compromise, the incidence of HL is lower in states of extreme immunodeficiency. It's possible that there was insufficient immunological contact between non-neoplastic inflammatory cells and HRS cells.[30]

Mechanism

HIV-positive patients have a higher incidence of malignancies for a variety of reasons. These consist of inflammation, cytokine dysregulation, and persistent antigenic stimulation.[15] Moreover, oncogenic viruses are more likely to infect HIV/AIDS patients.[31] Thus, a variety of factors, such as a compromised immune system, genetic changes, viral infection, and persistent B cell activation, contribute to the pathogenesis of HIV/AIDS-associated lymphoma.[15]

References

  1. ^ Besson C, Goubar A, Gabarre J, et al. (October 2001). "Changes in AIDS-related lymphoma since the era of highly active antiretroviral therapy". Blood. 98 (8): 2339–44. doi:10.1182/blood.V98.8.2339. PMID 11588028.
  2. ^ Rigolet A, Bossi P, Caumes E, et al. (September 2001). "Caractéristiques épidémiologiques et évolution de l'incidence des lymphomes cérébraux primitifs observés chez 80 patients infectés par le VIH entre 1983 et 1999" [Epidemiological features and incidence trends of primary cerebral lymphomas observed in 80 HIV-infected patients from 1983 to 1999]. Pathologie-biologie (in French). 49 (7): 572–5. doi:10.1016/S0369-8114(01)00206-1. PMID 11642021.
  3. ^ "AIDS-Related Lymphoma Treatment (PDQ®) - National Cancer Institute". Cancer.gov. 2012-05-18. Retrieved 2012-05-30.
  4. ^ "UpToDate". UpToDate. Retrieved February 10, 2024.
  5. ^ Heise, Walter (2010). "GI-lymphomas in immunosuppressed patients (organ transplantation; HIV)". Best Practice & Research Clinical Gastroenterology. 24 (1). Elsevier BV: 57–69. doi:10.1016/j.bpg.2010.01.001. ISSN 1521-6918.
  6. ^ Noy, Ariela (2020). "HIV Lymphoma and Burkitts Lymphoma". The Cancer Journal. 26 (3). Ovid Technologies (Wolters Kluwer Health): 260–268. doi:10.1097/ppo.0000000000000448. ISSN 1540-336X.
  7. ^ Abellán-Martínez, Javier; Guerra-Vales, Juan-Manuel; Fernández-Cotarelo, María-José; González-Alegre, María-Teresa (2009). "Evolution of the incidence and aetiology of fever of unknown origin (FUO), and survival in HIV-infected patients after HAART (Highly Active Antiretroviral Therapy)". European Journal of Internal Medicine. 20 (5). Elsevier BV: 474–477. doi:10.1016/j.ejim.2009.01.004. ISSN 0953-6205.
  8. ^ Carroll, Virginia; Garzino-Demo, Alfredo (June 29, 2015). "HIV-associated lymphoma in the era of combination antiretroviral therapy: shifting the immunological landscape". Pathogens and Disease. 73 (7). Oxford University Press (OUP): ftv044. doi:10.1093/femspd/ftv044. ISSN 2049-632X.
  9. ^ Brunnberg, Uta; Hentrich, Marcus; Hoffmann, Christian; Wolf, Timo; Hübel, Kai (2017). "HIV-Associated Malignant Lymphoma". Oncology Research and Treatment. 40 (3). S. Karger AG: 82–87. doi:10.1159/000456036. ISSN 2296-5270.
  10. ^ Xie, Yi; Pittaluga, Stefania; Jaffe, Elaine S. (2015). "The Histological Classification of Diffuse Large B-cell Lymphomas". Seminars in Hematology. 52 (2). Elsevier BV: 57–66. doi:10.1053/j.seminhematol.2015.01.006. ISSN 0037-1963.
  11. ^ a b Re, Alessandro; Cattaneo, Chiara; Rossi, Giuseppe (January 1, 2019). "HIV AND LYMPHOMA: FROM EPIDEMIOLOGY TO CLINICAL MANAGEMENT". Mediterranean Journal of Hematology and Infectious Diseases. 11 (1). Institute of Hematology, Catholic University. doi:10.4084/mjhid.2019.004. ISSN 2035-3006.
  12. ^ Magangane, Pumza S.; Mohamed, Zainab; Naidoo, Richard (February 24, 2020). "Diffuse large B-cell lymphoma in a high human immunodeficiency virus (HIV) prevalence, low-resource setting". South African Journal of Oncology. 4. AOSIS. doi:10.4102/sajo.v4i0.104. ISSN 2518-8704.
  13. ^ Wu, Dedong; Chen, Chen; Zhang, Mingzhi; Li, Zhaoming; Wang, Suqian; Shi, Jijing; Zhang, Yu; Yao, Dingzhu; Hu, Shuang (March 29, 2019). "The clinical features and prognosis of 100 AIDS-related lymphoma cases". Scientific Reports. 9 (1). Springer Science and Business Media LLC. doi:10.1038/s41598-019-41869-9. ISSN 2045-2322.
  14. ^ a b Meister, Anne; Hentrich, Marcus; Wyen, Christoph; Hübel, Kai (May 22, 2018). "Malignant lymphoma in the <scp>HIV</scp>‐positive patient". European Journal of Haematology. 101 (1). Wiley: 119–126. doi:10.1111/ejh.13082. ISSN 0902-4441.
  15. ^ a b c d e f g h i Berhan, Ayenew; Bayleyegn, Biruk; Getaneh, Zegeye (2022). "HIV/AIDS Associated Lymphoma: Review". Blood and Lymphatic Cancer: Targets and Therapy. 12. Informa UK Limited: 31–45. doi:10.2147/blctt.s361320. ISSN 1179-9889.
  16. ^ Shah, Hina J.; Keraliya, Abhishek R.; Jagannathan, Jyothi P.; Tirumani, Sree Harsha; Lele, Vikram R.; DiPiro, Pamela J. (2017). "Diffuse Large B-Cell Lymphoma in the Era of Precision Oncology: How Imaging Is Helpful". Korean Journal of Radiology. 18 (1). The Korean Society of Radiology: 54. doi:10.3348/kjr.2017.18.1.54. ISSN 1229-6929.
  17. ^ "HIV Associated Intra–oral Burkitt's Lymphoma: A Case Report". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. JCDR Research and Publications. 2013. doi:10.7860/jcdr/2013/6715.3862. ISSN 2249-782X.
  18. ^ a b Ansorge, Rick (November 1, 2021). "Burkitt Lymphoma: Diagnosis, Prognosis, Symptoms, and Treatments". WebMD. Retrieved February 11, 2024.
  19. ^ Dozzo, Massimo; Carobolante, Francesca; Donisi, Pietro Maria; Scattolin, Annamaria; Maino, Elena; Sancetta, Rosaria; Viero, Piera; Bassan, Renato (2016). "Burkitt lymphoma in adolescents and young adults: management challenges". Adolescent Health, Medicine and Therapeutics. 8. Informa UK Limited: 11–29. doi:10.2147/ahmt.s94170. ISSN 1179-318X.
  20. ^ Grommes, Christian; DeAngelis, Lisa M. (July 20, 2017). "Primary CNS Lymphoma". Journal of Clinical Oncology. 35 (21). American Society of Clinical Oncology (ASCO): 2410–2418. doi:10.1200/jco.2017.72.7602. ISSN 0732-183X.
  21. ^ Dunleavy, Kieron; Wilson, Wyndham H. (April 5, 2012). "How I treat HIV-associated lymphoma". Blood. 119 (14). American Society of Hematology: 3245–3255. doi:10.1182/blood-2011-08-373738. ISSN 0006-4971.
  22. ^ Zhao, Hui; Ma, Miao; Zhang, Limin; Zheng, Guanghui; Lv, Hong; Liu, Jie; Li, Xiao; Song, Bei; Zhang, Guojun (May 7, 2019). "Diagnosis of central nervous system lymphoma via cerebrospinal fluid cytology: a case report". BMC Neurology. 19 (1). Springer Science and Business Media LLC. doi:10.1186/s12883-019-1317-3. ISSN 1471-2377.
  23. ^ Jarrett, Ruth F (December 17, 2005). "Viruses and lymphoma/leukaemia". The Journal of Pathology. 208 (2). Wiley: 176–186. doi:10.1002/path.1905. ISSN 0022-3417.
  24. ^ Antar, A; El Hajj, H; Jabbour, M; Khalifeh, I; EL-Merhi, F; Mahfouz, R; Bazarbachi, A (March 7, 2014). "Primary effusion lymphoma in an elderly patient effectively treated by lenalidomide: case report and review of literature". Blood Cancer Journal. 4 (3). Springer Science and Business Media LLC: e190–e190. doi:10.1038/bcj.2014.6. ISSN 2044-5385.
  25. ^ Narkhede, Mayur; Arora, Shagun; Ujjani, Chaitra (2018). "Primary effusion lymphoma: current perspectives". OncoTargets and Therapy. 11. Informa UK Limited: 3747–3754. doi:10.2147/ott.s167392. ISSN 1178-6930.
  26. ^ Castillo, Jorge J.; Bibas, Michele; Miranda, Roberto N. (April 9, 2015). "The biology and treatment of plasmablastic lymphoma". Blood. 125 (15). American Society of Hematology: 2323–2330. doi:10.1182/blood-2014-10-567479. ISSN 0006-4971.
  27. ^ Elyamany, Ghaleb; Al Mussaed, Eman; Alzahrani, Ali Matar (2015). "Plasmablastic Lymphoma: A Review of Current Knowledge and Future Directions". Advances in Hematology. 2015. Hindawi Limited: 1–11. doi:10.1155/2015/315289. ISSN 1687-9104.
  28. ^ Broccoli, Alessandro; Nanni, Laura; Stefoni, Vittorio; Agostinelli, Claudio; Argnani, Lisa; Cavo, Michele; Zinzani, Pier Luigi (June 8, 2018). "A patient with plasmablastic lymphoma achieving long-term complete remission after thalidomide-dexamethasone induction and double autologous stem cell transplantation: a case report". BMC Cancer. 18 (1). Springer Science and Business Media LLC. doi:10.1186/s12885-018-4561-9. ISSN 1471-2407.
  29. ^ Ul-Haq, Ikram; Dalla Pria, Alessia; Suardi, Elisa; Pinato, David J.; Froeling, Fieke; Forni, John; Randell, Paul; Bower, Mark (March 13, 2018). "Blood Epstein–Barr virus DNA does not predict outcome in advanced HIV-associated Hodgkin lymphoma". Medical Oncology. 35 (4). Springer Science and Business Media LLC. doi:10.1007/s12032-018-1099-2. ISSN 1357-0560.
  30. ^ Grogg, K L; Miller, R F; Dogan, A (December 20, 2006). "HIV infection and lymphoma". Journal of Clinical Pathology. 60 (12). BMJ: 1365–1372. doi:10.1136/jcp.2007.051953. ISSN 0021-9746.
  31. ^ Yarchoan, Robert; Uldrick, Thomas S. (March 15, 2018). "HIV-Associated Cancers and Related Diseases". New England Journal of Medicine. 378 (11). Massachusetts Medical Society: 1029–1041. doi:10.1056/nejmra1615896. ISSN 0028-4793.

Further reading

External links

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