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Ask the Experts about Opportunistic Infections

 

Primary Lymphoma
Aug 23, 2001

Hi

How often is primary lymphoma seen in HIV patients? Is the patient usually real sick prior to this or can it come on at anytime?

Response from Dr. Feinberg

You are confusing 2 different diseases: primary CNS (central nervous system) lymphoma, and systemic lymphoma. Primary CNS lymphoma is not common and occurs in very advanced HIV (AIDS, with CD4 cells usually less than 50). Systemic lymphoma (meaning it occurs somewhere in the body but not in the CNS) is more common and occurs in HIV- adults as well as HIV+s. Because it can develop in HIV-s, it can occur at any CD4 cell count-- I've seen a case in a man with over 900 CD4 cells-- although the tendency is for it to occur when CD4 cell counts are already subnormal. While this can be the first manifestation of HIV disease, it usually follows other HIV-associated proble4ms.



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