The spectrum of mucosa-associated lymphoid tissue lesions in pediatric patients infected with HIV: A clinicopathologic study of six cases

Vijay V. Joshi, Gregory A. Gagnon, Ellen G. Chadwick, Costan W. Berard, Kenneth L. Mcclain, Charles T. Leach, Harold B. Jenson, Sharon B. Murphy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Mucosa-associated lymphoid tissue (MALT) lesions in nonimmunocompromised individuals include reactive lymphoid proliferations and both low- and high- grade lymphoid neoplasms. These lesions occur at extranodal mucosal sites, such as the gastrointestinal tract, bronchus, salivary gland, and other locations. The spectrum of MALT lesions in children with HIV infection had not been previously described. In this study, six cases that demonstrated the spectrum of MALT lesions in pediatric patients, aged 28 months to 23 years, who had HIV infection were described. Half the patients acquired the infection perinatally, and half acquired it by transfusion. Mucosal sites of involvement included the salivary gland (4 patients), bronchiolar mucosa (2 patients), and oropharyngeal mucosa (1 patients). One patient had lesions in lung and oropharynx sequentially; all others had involvement of solitary sites. The histologic diagnoses included myoepithelial sialadenitis (MESA), MESA with low-grade MALT lymphoma, typical low-grade MALT lymphoma, diffuse large cell lymphoma (DLCL), and a typical pulmonary lymphoid hyperplasia and lymphoid interstitial pneumonitis complex. The two cases of high-grade DLCL were confined to mucosal sites (tonsil and parotid); in one of these patients, a previous biopsy specimen showed a MALT lesion with low-grade features. In two cases, quantitation of the Epstein-Barr virus (EBV) genome by the polymerase chain reaction showed a very high copy number in peripheral blood mononuclear cells but a low copy number in the MALT lesion, which suggested that MALT lesions may not be directly associated with EBV infection. Two patients who had high-grade tumors (DLCL) were successfully treated with chemotherapy and radiation therapy. The remaining patients, all of whom had low-grade MALT lesions, received either corticosteroids or x- interferon or no specific therapy; in all patients, the lesions followed an indolent clinical course. Clinicians and pathologist should be alert to the possibility that MALT lymphomas, may be present in children who have AIDS.

Original languageEnglish (US)
Pages (from-to)592-600
Number of pages9
JournalAmerican journal of clinical pathology
Volume107
Issue number5
DOIs
StatePublished - May 1997

Keywords

  • Bronchi
  • HIV
  • Lymphoma
  • Mucosa-associated lymphoid tissue
  • Pediatrics
  • Salivary gland

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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