The most common site of lymphoma in AIDS is:
Correct Answer: CNS
Description: Ans. A. CNS. (Ref. Q. 168 of MH'2006 paper; Harrison 18th/ch. 189)Lymphomas occur with an increased frequency in patients with congenital or acquired T cell immunodeficiencies. AIDS is no exceptio patients with AIDS develop lymphoma at some time during the course of their illness. This is a 120-fold increase in incidence compared with the comparison to the situation with KS, primary CNS lymphoma, and most opportunistic infections, the incidence of AIDS-associated systemic lymph experienced as dramatic a decrease as a consequence of the widespread use of effective cART. Locations that are most commonly involved with CNS lymphoma are deep in the white matter. The main diseases in the different cerebral toxoplasmosis and cerebral Chagas' disease.Three main categories of lymphoma are seen in patients with HIV infection: grade III or IV immunoblastic lymphoma,Burkitt's lymphoma, and pr lymphoma. Approximately 90% of these lymphomas are B cell in phenotype; more than half contain EBV DNA. Immunoblastic lymphomas account for >60% of the cases of lymphoma in patients with AIDS. The majority of these are diffuse large B cell lymp are generally high grade and would have been classified as diffuse histiocytic lymphomas in earlier classification schemes.Small noncleaved cell lymphoma (Burkitt's lymphoma) accounts for 20% of the cases of lymphoma in patients with AIDS. It is most frequent in years old and usually demonstrates characteristic c-myc translocations from chromosome 8 to chromosomes 14 or 22. Burkitt's lymphoma is not setting of immunodeficiency other than HIV-associated immunode- ficiency, and the incidence of this particular tumor is more than 1000-fold highe infection than in the general population.In contrast to African Burkitt's lymphoma, where 97% of the cases contain EBV genome, only 50% of HI lymphomas are EBV-positive.Primary CNS Ixmphoma accounts for 20% of the cases of lymphoma in patients with HIV infection. In contrast to HIV-asso Burkitt's lymph lymphomas are usually positive for EBV. In one study, the incidence of Epstein-Barr positivity was 100%. This malignancy does not have a predil particular age group. The median CD4+ T cell count at the time of diagnosis is 50/ L. Thus, CNS lymphoma generally presents at a later stage o does systemic lymphoma. This may explain, at least in part, the poorer prognosis for this subset of patients.
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