Malignant Gastrointestinal Lymphomas in Patients with AIDS

• Published in: Digestion Vol. 58; no. 3; pp. 218 - 224
• Main Authors: Heise, Walter, Arastéh, Keikawus, Mostertz, Peter, Skörde, Jürgen, Schmidt, Wolfgang, Obst, Christopher, Koeppen, Michael, Weiss, Rudolf, Grosse, Gernot, Niedobitek, Fred, L’Age, Manfred
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.1997; S. Karger AG
• Subjects: Adult; AIDS/HIV; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biopsy; CD4 Lymphocyte Count; Endoscopy, Gastrointestinal; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Neoplasms - drug therapy; Gastrointestinal Neoplasms - mortality; Gastrointestinal Neoplasms - pathology; Humans; Immunohistochemistry; Lymphoma, AIDS-Related - drug therapy; Lymphoma, AIDS-Related - mortality; Lymphoma, AIDS-Related - pathology; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - pathology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Original Paper; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Rate; Tumors; Malignant lymphoma; Gastrointestinal tract; Endoscopy; HIV infection; Prognosis; Gastrointestinal; Histopathology; Lymphoproliferative syndrome; Intestinal disease; Lentivirinae; Complication; Gastric disease; Human; Immunopathology; Evaluation; Radiodiagnosis; Retroviridae; AIDS; Malignant hemopathy; Medical screening; Immune deficiency; Infection; Virus; Treatment; Viral disease; Digestive diseases; Medical imagery; Human immunodeficiency virus
• ISSN: 0012-2823; 1421-9867
• DOI: 10.1159/000201447

HIV-associated malignant lymphomas are a common complication in late HIV infection, and there is a high percentage of gastrointestinal tract involvement. Non-Hodgkin’s lymphoma was found in 108 of 2,750 HIV-positive patients (3.9%) in our institution, whereas gastrointestinal manifestation was diagnosed in 48 of 108 patients (44.4%). 44 of these cases were found during endoscopy of the upper and lower gastrointestinal tract (or by laparotomy or laparoscopy in 4 cases). Endoscopy is a reliable procedure for the diagnosis of lymphoma. Unusual manifestations such as oral, esophageal or perianal lesions and multifocal disease were common findings. Life-threatening complications such as gastrointestinal bleeding, perforation, and obstruction occurred in 37.5%. High-grade B-cell lymphomas were found in all cases including mainly lymphoblastic, immunoblastic, centroblastic and Burkitt subtypes. 52% of the patients had disseminated lymphoma with Ann Arbor stage III or IV. Standard chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisone was started in 25 patients and resulted in a mean survival time of 4.8 months. The prognosis of AIDS patients presenting with malignant gastrointestinal lymphoma depends mainly on the presence or absence of previous AIDS-defining diseases, not CD4 cells, lymphoma-associ-ated gastrointestinal complications or the histopathologic lymphoma type at the time of diagnosis.