Non‐hodgkin's lymphomas in patients with human immunodeficiency virus infection. Presence of epstein–barr virus by In situ hybridization, clinical presentation, and follow‐up

The authors studied all patients with serologic evidence of human immunodeficiency virus (HIV) infection and malignant non‐Hodgkin's lymphoma (NHL) that presented at a single hospital from 1982 to 1989. Sixteen patients were identified, all white homosexual men with a mean age of 38.2 years. Lymphoma was the initial presentation of HIV infection in 37.5%. Sixty‐two percent of the cases had a high‐grade NHL, 31% had intermediate‐grade, and 6% (one patient) had a low‐grade lymphoplasmacytoid lymphoma. Extranodal involvement was present in 43.7%, with the gastrointestinal tract and liver being the most common sites. Actuarial survival was increased by treatment with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP‐B). Colorimetric in situ hybridization identified Epstein–Barr virus (EBV) in nine of the 14 cases hybridized. A statistically significant association of EBV with diffuse small noncleaved type (i.e., Burkitt's‐like) (six of six) compared with other morphologic types (three of eight) was found (P = 0.025). 68:2460‐2465, 1991.