Lymphoproliferative disorder of the central nervous system in AIDS

Primary lymphoproliferative disorders of the central nervous system are relatively infrequent. An increased incidence has been noted in patients with congenital immunocompromised states (for example, Wiskott-Aldrich syndrome) as well as acquired immunodeficiencies, as in transplant recipients following immunosuppressive therapy. Since the recognition of the acquired immune deficiency syndrome (AIDS) in 1981, some affected patients have developed malignant lymphoma. A significant proportion of these tumors have involved the central nervous system, primarily or exclusively. The spectrum of lymphoproliferation in AIDS, which ranges from hyperplasia to lymphoma, may at times present difficulties in distinguishing a reactive from a neoplastic process. We report a patient with AIDS who developed a cerebral mass lesion which was characterized at postmortem examination as a primary lymphoproliferative process.