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  • Title: Clonal ambiguity of human immunodeficiency virus-associated lymphomas. Similarity to posttransplant lymphomas.
    Author: Lippman SM, Volk JR, Spier CM, Grogan TM.
    Journal: Arch Pathol Lab Med; 1988 Feb; 112(2):128-32. PubMed ID: 3257381.
    Abstract:
    Initial biopsy specimens from two patients with lymphadenopathy and human immunodeficiency virus antibody-positive serum presented considerable difficulty in making specific histologic and immunologic diagnoses, although subsequent biopsy specimens revealed clear progression to acquired immunodeficiency syndrome (AIDS)-associated lymphomas. The initial biopsy specimens revealed multifocal clusters of large blastic lymphoid cells, with some clusters showing a monoclonal lambda light chain predominance, whereas other clusters showed a kappa predominance, indicating considerable phenotypic ambiguity suggestive of polyclonality. This initial clonal ambiguity was followed within two to three months by overt histologic, phenotypic, and clinical malignant transformation to a diffuse high-grade monoclonal B-cell lymphoma. These data have significant implications for the clonality and pathogenesis of AIDS-associated lymphoproliferative disorders. AIDS-related lymphomas may evolve from an initial multiclonal B-cell expansion similar to that described in other severely immunosuppressed patients (eg, with posttransplantation lymphoma).
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