Hodgkin's disease of the head and neck in human immunodeficiency virus–infected patients

• Published in: American journal of otolaryngology Vol. 23; no. 1; pp. 12 - 16
• Main Authors: Poluri, Ashok, Shah, Kavin G., Carew, John F., Shaha, Ashok R., Har-El, Gady, Lucente, Frank E., Singh, Bhuvanesh
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-01-2002; Elsevier
• Subjects: Adult; Biological and medical sciences; Case-Control Studies; Female; Hematologic and hematopoietic diseases; HIV Infections - complications; HIV Seronegativity; Hodgkin Disease - complications; Hodgkin Disease - epidemiology; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Neoplasm Staging; Survival Rate; Human; HIV-1 virus; Retroviridae; Hodgkin disease; Malignant hemopathy; Lentivirus; Lymphoma; Infection; Virus; Lymphoproliferative syndrome; Viral disease; Head and neck; Human immunodeficiency virus; Comparative study
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1053/ajot.2002.28778

Introduction: Hodgkin's disease can occur in immunocompromised patients. However, the head and neck manifestations of Hodgkin's disease in human immunodeficiency virus (HIV)–infected patients remain ill defined. The aim of this study was to describe Hodgkin's disease of the head and neck in HIV-infected patients and compare it with noninfected patients. Materials and Results: Sixteen patients presented with Hodgkin's disease of the head and neck to the King's County Hospital Center, Brooklyn, New York, beginning in January of 1991. Five patients were infected with HIV. Hodgkin's disease involved the head and neck regions in 90.5% of cases, occurring in 100% of HIV-infected and in 81% of noninfected patients. Manifestations of Hodgkin's disease were isolated to the head and neck region in only 20% of HIV-infected and in 27% of noninfected patients. Lymphatic structures were involved in all cases with head and neck involvement. Systemic or group B symptoms (fever, night sweats, fatigue, and weight loss of more than 10% of normal body weight) were present in 40% of HIV-infected patients and in 27% of noninfected patients. Advanced stage disease (Stage III/IV) was diagnosed in 80% of HIV-infected patients compared with 45% of noninfected patients. The mixed cellularity subtype was most common in HIV-infected patients (75%), whereas the nodular sclerosis subtype predominated in noninfected patients (50%). Conclusions: The data combined with our report of the literature suggest that the course, presentation, and outcome of Hodgkin's disease is markedly altered in HIV-infected patients. An aggressive approach to the diagnosis and management is suggested in this patient population. (Am J Otolaryngol 2002;23:12-16. Copyright © 2002 by W.B. Saunders Company)