Novel insights into the early histopathogenesis of immunodeficiency-associated Burkitt lymphoma: a case report of Burkitt microlymphoma arising within HIV lymphadenitis

Histopathology. 2016 Sep;69(3):516-21. doi: 10.1111/his.12960. Epub 2016 May 20.

Abstract

Aims: To report a case detailing the early histopathogenesis of Burkitt lymphoma (BL), Epstein-Barr virus (EBV) positive, in the clinical setting of HIV infection.

Methods and results: We describe a 57 year-old woman with newly diagnosed HIV infection who presented with unilateral localized axillary lymphadenopathy. Histopathological, immunohistochemical, and flow cytometric analyses were performed and showed EBV-positive nests of Burkitt cells, including rare nests also positive for cytomegalovirus, exclusively located within hyperplastic monocytoid B-cell areas of HIV lymphadenitis. Due to positron emission tomography/computed tomography findings of persistent localized lymphadenopathy with markedly increased fludeoxyglucose avidity a core needle biopsy was performed. Histopathological, immunohistochemical, fluorescence in situ hybridization, and flow cytometric analyses confirmed BL.

Conclusions: Early histopathogenesis of HIV-associated BL occurred as nests of EBV-positive Burkitt cells within prominent monocytoid B-cell areas in our case. The results equip the pathologist to identify a very subtle Burkitt microlymphoma which would allow for prompt and appropriate chemotherapeutic intervention and may promote research into the possible relationship between monocytoid B cells and BL.

Keywords: Burkitt lymphoma; Epstein-Barr virus; cytomegalovirus; human immunodeficiency virus; monocytoid.

Publication types

  • Case Reports

MeSH terms

  • Burkitt Lymphoma / complications*
  • Burkitt Lymphoma / diagnosis*
  • Female
  • Flow Cytometry
  • HIV Infections / complications*
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Lymphadenitis / etiology*
  • Middle Aged
  • Positron Emission Tomography Computed Tomography