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Medicine Infection f41c6fb3

False about lymphoma in AIDS patients

A
Intranodal
B
Extranodal
C
Highly aggressive
D
Less responsive to treatment
High-Yield Explanation
Ans: d (less respon...). Ref: Harrison 17th ed/ p. 1188, 1189The treatment response for lymphoma in AIDS patient is as high as 72%Lymphoma in AIDSClinical features* High grade* Lymphadenopathy* Extranodal involvement- most common site is CNS* Disseminated diseaseThree main categories of lymphoma are seen in patients with HIV infection:-* Grade III or IV immunoblastic lymphoma* Burkitf s lymphoma* Primary CNS lymphomai) Immunoblastic lymphoma* 60% of the cases of lymphoma in patients with AIDS.* High grade* Seen in older patients* One variant - body cavity lymphoma (lymphomatous pleural, pericardial, peritoneal effusions in absence of intranodal or extranodal masses).* HHV-8 DNA sequences in these malignant cellsii) Burkitt's lymphoma (small noncleaved cell lymphoma)* 20% of cases* Seen in 10-19 years old* Characteristic c-myc translocations from chromosome 8 to chromosome 14 or 22* Only 50% of HIV associated Burkitt's lymphoma are EB V-positive.iii) Primary CNS lymphoma* 20% of cases* No age predilection* EBV positive* Seen in later stage of HIV, so poorer prognosis.Response to treatment is as high 72%.Note:-Multicentric Castleman's disease is a HHV-8 associated lymphoproliferative disorder.Lymph node biopsies show onion skin appearance (hyaline vascular)

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