The Spontaneous Regression Of Lymphoma In Aids
Daniels, D., Lowdell, C. P., & Glaser, M. G. (1992). The spontaneous regression of lymphoma in AIDS. Clinical oncology (Royal College of Radiologists (Great Britain)), 4(3), 196–197. https://doi.org/10.1016/s0936-6555(05)81090-8
View Original Source →Abstract
Non-Hodgkin's lymphomas are an increasing problem in the AIDS population. They are generally aggressive, high-grade lymphomas and more commonly present at extranodal sites, particularly the central nervous system. Although chemo- and radiosensitive, the duration of response is generally short lived. Spontaneous remission of non-Hodgkin's lymphomas has been reported in immunocompetent individuals, but has not been reported in HIV disease. We would like to report the first such case.
Case Details
Disease Location
Right para-pharyngeal, infratemporal fossa, larynx cervical ln right testicle
Personal Characteristics
43 -year-old male homosexual HIV seropositive in april 1989, he also suffered from polycystic kidney disease and had stable mild renal failure.
Clinical Characteristics
That same year he presented with pharyngeal discomfort and hoarseness indirect laryngoscopy suggested a right para-pharyngeal mass and demonstrated a vocal cord palsy findings were confirmed on computed tomographic scanning and the mass was shown to extend into the infratemporal fossa and to the level of the larynx a repeat laryngoscopy was performed 3 weeks later, prior to admission for exam under anesthetic and biopsy at the exam, complete regression occured 2 months later he re-presented with a firm non-tender cervical mass measuring 11x7cm which had gradually enlarged over 1 week, also he had bilateral palpable polycystic kidneys needle aspiration cytology showed high-grade b-cell lymphoma CD4 lymphocyte count was 370/mm^3 (17%) the mass resolved 14 months later he presented with right testicular mass which gradually enlarged painlessly over 1 week orchidectomy revealed a high-grade large cell immunoblastic lymphoma, and repeat staging showed marked infiltration of the left psoas and iliacus muscles, CD4 count was 187/mm^3 (16%) his condition deteriorated rapidly despite chemo with bleomycin and vincristine he developed progressive renal failure and died
Remission Characteristics
At the exam 3 weeks after repeat laryngoscopy, complete regression of the mass had occurred and his symptoms improved during staging of the cervical mass, the mass resolved spontaneously with no residual tumor after 10 days the patient remained well, without further symptomatic HIV disease, for 14 months with a stable CD4 count
Treatment & Mechanisms
Proposed Remission Mechanisms
Various host immunological factors (bacterial or viral infection and increased immuno-regulation) immunoregulation is likely to have played a major part in this case
Clinical Treatment
Bleomycin and vincristine
Non-Clinical Treatment
None reported