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Development of B-Cell Lymphoma in Homosexual Men Clinical and Immunologic Findings

ALEXANDRA M. LEVINE, M.D.; PAUL R. MEYER, M.D.; MARK K. BEGANDY, M.D.; JOHN W. PARKER, M.D.; CLIVE R. TAYLOR, M.D., D. Phil.; LOWELL IRWIN, M.D.; and ROBERT J. LUKES, M.D.
[+] Article and Author Information

Grant support: In part by the U. S. Public Health Service Grant 5P01 CA 19449, awarded by the National Cancer Institute, Department of Health and Human Services.

▸Requests for reprints should be addressed to Alexandra M. Levine, M.D.; Department of Internal Medicine, Los Angeles County-University of Southern California Medical Center, Unit 1, Room 14-442, 1200 North State Street; Los Angeles, CA 90033.


Los Angeles, California


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;100(1):7-13. doi:10.7326/0003-4819-100-1-7
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Serious infections, neoplasms, and immunologic abnormalities have been found in homosexual men. We describe the development of malignant lymphoma in six such patients, three of whom had persistent, generalized lymphadenopathy. In biopsies done before the lymphoma developed, the lymphadenopathy was characterized morphologically by a distinctive pattern of B-cell follicular hyperplasia. All lymphomas were of B-lymphocytic origin, including B-cell immunoblastic sarcoma; small noncleaved, Burkitt-like lymphoma; and plasmacytoid lymphocytic lymphoma. Extranodal presentation with B symptoms occurred in five patients. Median age of our patients was 33 years. Three patients had histories of repeated systemic infections. The peripheral blood lymphocyte count was depressed in four, with depression of OKT 4+ (helper phenotype) cell levels and reversal of the T-helper:T-suppressor ratio in all. We conclude that these patients are at risk for the development of abnormalities of the B-lymphocytic system, manifested by abnormal hyper-B-cell response in enlarged reactive lymph nodes and aggressive, extranodal B-cell lymphomas.

Topics

immunology ; lymphoma

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