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1995-03-25
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Document 0819
DOCN M9550819
TI [Cerebral lymphoma in AIDS: clinical study and clinicopathological
correlations]
DT 9505
AU Marelle L; Raphael M; Henin D; Vazeux R; Schuller E; Piette JC; Poisson
M; Gentilini M; Hauw JJ; Laboratoire de Neuropathologie R. Escourolle,
Centre d'Ecologie; cellulaire, Departement d'Hematologie, Hopital de La;
Salpetriere, Paris.
SO Rev Neurol (Paris). 1994;150(2):123-32. Unique Identifier : AIDSLINE
MED/95167303
AB We report the natural history of 17 brain lymphomas (11 primary, 6
disseminated) from a post-mortem series of 130 patients with AIDS.
Primary lymphomas appeared lately in the course of AIDS. They were often
associated with a severe T-cell immunodepression and with more frequent
opportunistic disorders than disseminated lymphomas. Associated Kaposi's
sarcomas were surprisingly frequent. All patients presented with
neurological manifestations. Heterogeneous features were seen at CT
examination. The CSF was abnormal in 12/13 cases, with an increase of
protein contents and secretion of immunoglobulins; it contained
activated lymphocytes in 5/6 cases of disseminated lymphomas, and
malignant cells in only one case. Cellular density never exceeded 8/mm3
for primary lymphomas, and the lymphocytes were considered normal. The
pre-mortem diagnosis of cerebral lymphomas was made in five patients,
with a time lapse of 1 to 7 months between the first neurological
symptoms and death, and of 5 to 30 days between the diagnosis and death.
Cerebral biopsy was diagnostic in 4 cases of primary cerebral lymphomas.
In only 1/6 patients with disseminated lymphomas, the diagnosis had been
made when the patient was still alive, based on CSF and bone marrow
lymphomatous infiltrations. The diagnosis of cerebral lymphoma (7
primary, 5 disseminated) was post-mortem in 12 cases. It was made only
at microscopic examination in 2/12 cases of primary lymphomas. The
histopathological study frequently showed a multicentric involvement,
and always an immunoblastic cell type with plasmablastic differentiation
and frequent medium size cells. Marked gliosis and significant necrosis
were often observed. Neuropathological lesions associated with HIV-1
infection (toxoplasmosis, CMV and HIV-1 encephalitis) were seen in 8
cases with primary lymphomas.
DE Adult Brain Neoplasms/*DIAGNOSIS/ETIOLOGY English Abstract Human
Lymphoma, AIDS-Related/COMPLICATIONS/*DIAGNOSIS/PATHOLOGY Male Middle
Age Neoplasms, Multiple Primary/DIAGNOSIS Nervous System
Diseases/ETIOLOGY Sarcoma, Kaposi's/DIAGNOSIS/*ETIOLOGY JOURNAL
ARTICLE REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).