Non-Hodgkins's lymphoma of the buccal gingiva as the initial manifestation of AIDS

Abstract

The case definition of acquired immunodeficiency syndrome (AIDS) has recently been revised to include patients with non-Hodgkin’s lymphoma of a high-grade pathologic type (diffuse, undifferentiated) and of B-cell or unknown immunologic phenotype diagnosed by biopsy, as long as the result of the serologic or virologic test is positive for human immunodeficiency virus (HIV).’ These lymphomas generally occur in extranodal sites in the advanced stages, and have a much worse prognosis than those seen in the general population. They are clinically very aggressive and often display an incomplete response to chemotherapy or radiotherapy.* NonHodgkin’s lymphoma and AIDS occurring concurrently in a patient confer a poor prognosis, not only because of the sequelae of progressive lymphoma, but also because of an increased incidence of opportunistic infection.3 Since the outbreak of the AIDS epidemic there has been a steady increase in the numbers of nonHodgkin’s lymphoma observed in homosexual males. In a multicenter collaborative study from San Francisco, Los Angeles, Houston, and New York,4 non-Hodgkin’s lymphoma was found in 90 homosexual males. The unusual sites of these lymphomas, possibly related to the route of sexual intercourse involved, included intraoral and anorectal locations. The clinician may erroneously assume that any