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

Abstract

Serious infections, neoplasms and immunologic abnormalities have been found in homosexual men. Development of malignant lymphoma in 6 such patients, 3 of whom had persistent, generalized lymphadenopathy, is described. 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 5 patients. Median age of the patients was 33 yr. Three patients had histories of repeated systemic infections. Peripheral blood lymphocyte count was depressed in 4, with depression of OKT 4+ (helper phenotype) cell levels and reversal of the T-helper:T-suppressor ratio in all. These patients are at risk for development of abnormalities of the B-lymphocytic system, manifested by abnormal helper-B-cell response in enlarged reactive lymph nodes and aggressive, extranodal B-cell lymphomas.