Abstract
Lymphoma in HIV-infected patients is AIDS defining. This is the second most common AIDS defining malignancy after Kaposi’s sarcoma. Development of lymphoma in HIV patients is related to immunosuppression and high viral load. Co-infection with other lymphotrophic viruses especially EBV is also strongly associated with development of lymphoma in HIV patients. Despite advances in HAART therapy, incidence of diffuse large B cell lymphoma in HIV-infected patients remains significantly higher than in the general population.Early diagnosis is challenging due to presence of opportunistic infections and atypical presentation of the lymphoma in this subset of patients. Atypical imaging findings are not unusual, and the diagnosis of lymphoma on imaging is on many occasions unexpected as the patient would ideally be initially investigated for presumed opportunistic infection.Lymphoma treatment approaches in HIV patients are complicated by comorbidity with opportunistic infections and performance status of the patients. Treatment failure and early relapse are also common in AIDS-related lymphoma. This review article highlights the common and unusual multimodality imaging findings in HIV-associated lymphoma.
Highlights
Human immunodeficiency virus (HIV) remains a critical health problem; as of 2018, 37.9 million people globally were living with HIV, of which 24.5 million had access to highly active antiretroviral therapy (HAART) [1]
Imaging with Positron emission tomography (PET) Computed tomography (CT) is not recommended for posttreatment surveillance due to high false positive rates
The false positive rates could even be higher in HIV patients due to some opportunistic infections which may have presentation similar to that of lymphoma
Summary
HIV remains a critical health problem; as of 2018, 37.9 million people globally were living with HIV, of which 24.5 million had access to highly active antiretroviral therapy (HAART) [1]. 75% of the non-Hodgkin’s lymphoma in HIV patients is aggressive diffuse large B cell lymphoma (DLBCL). Besides the established imaging findings of nodal enlargement in HIV negative patients, other unusual findings are not uncommon in AIDSrelated lymphoma These include necrosis of the involved nodes, large extranodal soft tissue masses, and bone destruction secondary to lymphoma involvement. AIDS-related lymphoma presents with multi-organ involvement and bulky disease [10]. 18 FDG PET/CT is a useful tool in initial staging and response assessment of lymphoma in both HIV-positive and HIV-negative patients [11, 12]. The high-grade HIV-associated DLBCLs are more likely to show avid uptake of 18 F-FDG. Liver and spleen Liver and spleen involvement are not uncommon in AIDS-related lymphoma This can either be focal or diffuse involvement, with hepatosplenomegaly and focal masses on imaging. The false positive rates could even be higher in HIV patients due to some opportunistic
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
