Background: Aggressive non-Hodgkin's lymphomas are common among patients infected with HIV. Although such lymphomas are mostly of the B-cell type, various cases of cutaneous T-cell lymphoma (CTCL) have also been reported. Recent reports suggest that some HIV-related lymphoproliferative conditions may not be clonal processes, but polyclonal lymphoid proliferations. Objective: We reviewed our experience with HIV patients seen at the dermatology clinics for possible CTCL. Methods: A retrospective study was performed to evaluate clinical, laboratory, and histologic findings of HIV- infected patients with atypical T-cell cutaneous infiltrates. Results. We observed 9 patients with advanced HIV infection and a cutaneous eruption characterized by a dense infiltrate of lymphocytes resembling mycosis fungoides histopathologically, but composed of CD8+ cells. Although clonality was not identified in any of the 6 cases tested, 3 patients had similar CD8+ infiltrates involving lymph nodes or bone marrow. Of the 9 patients, 8 died of AIDS wasting syndrome or infections in less than 1 year. Conclusion: Cutaneous and systemic infiltrates with polyclonal CD8 T lymphocytes can be seen in patients with advanced HIV infection and profound CD4 lymphopenia. The clinical presentation may resemble CTCL and is associated with a poor outcome.
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