Major clinical features and laboratory findings in lymphomas and MCD occurring in individuals infected by HIV
| Histotype . | Common presentation . | CD4/μL at diagnosis . | Clinical features . |
|---|---|---|---|
| BL | Nodal, extranodal, bone marrow | >200* | Increasing prevalence in cART era Improved outcomes in cART era Only in EBV+, immunoblastic plasmacytoid morphology |
| DLBCL† | Nodal and extranodal | <200 | The most common lymphoma Late manifestation of HIV infection May have CNS involvement Improved outcome in cART era |
| PEL | Effusions; nodal and extranodal presentations are found (solid PEL) | <100 | Concurrent Kaposi sarcoma common Aggressive behavior Poor prognosis |
| PBL | Extranodal, oral cavity or other extranodal or nodal sites | <200 | Aggressive behavior Poor prognosis |
| MCD-associated large cell lymphoma | Extranodal and nodal | >200 | Aggressive behavior Poor prognosis |
| MCD | Nodal | >200 | Severe B symptoms Increased KSHV viral load and elevated levels of circulating vIL6, h-IL6, and IL10 |
| HL | Nodal and extranodal | ≈200 | Increased incidence over time (SIR 22) Good prognosis |
| Histotype . | Common presentation . | CD4/μL at diagnosis . | Clinical features . |
|---|---|---|---|
| BL | Nodal, extranodal, bone marrow | >200* | Increasing prevalence in cART era Improved outcomes in cART era Only in EBV+, immunoblastic plasmacytoid morphology |
| DLBCL† | Nodal and extranodal | <200 | The most common lymphoma Late manifestation of HIV infection May have CNS involvement Improved outcome in cART era |
| PEL | Effusions; nodal and extranodal presentations are found (solid PEL) | <100 | Concurrent Kaposi sarcoma common Aggressive behavior Poor prognosis |
| PBL | Extranodal, oral cavity or other extranodal or nodal sites | <200 | Aggressive behavior Poor prognosis |
| MCD-associated large cell lymphoma | Extranodal and nodal | >200 | Aggressive behavior Poor prognosis |
| MCD | Nodal | >200 | Severe B symptoms Increased KSHV viral load and elevated levels of circulating vIL6, h-IL6, and IL10 |
| HL | Nodal and extranodal | ≈200 | Increased incidence over time (SIR 22) Good prognosis |
See Oksenhendler et al,14 Carbone et al,18,37 and Gopal et al.25
CD4 counts are often normal in patients with BL, and BL often presents when there is no overt evidence of immune suppression.
Primary central nervous system lymphoma, which is nearly EBV+ in the setting of HIV, should be distinguished from other DLBCL.