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John Mihran Davis, MD; Amy Chadburn, MD; Janet A. Mouradian, MD

Arch Surg. 1988;123(11):1349-1352.

Abstract
• Twenty-one male homosexuals were followed up by repeated lymph node biopsy for a mean (±SEM) follow-up of 99±18 weeks. Four histologic patterns were seen on biopsy: explosive follicular hyperplasia (EFH), follicular involution (FI), a mixed pattern of EFH with FI in the same node, and lymphocyte depletion. Patients with FI and lymphocyte depletion had mean survival times that were significantly less than those for the subjects with EFH. The percentage of lymph node follicles with suppressor cell clusters (T8) in EFH lymph nodes was significantly higher (43% vs 8%) than in nodes from patients without risk for human immunodeficiency virus infection. Helper/suppressor T-cell ratios in control nodes were 1.6; in EFH nodes, 0.97; and in FI nodes, 0.88. A remarkable 33% of patients in this lymphadenopathy group ultimately developed large-cell (B-cell) lymphoma, suggesting that the follicular stimulation noted histologically played a role in the development of this neoplasm. These data show that there is a progressive destruction of lymph node follicles that correlates with the progression of the disease and that lymph node histologic features may provide important prognostic information.

(Arch Surg 1988;123:1349-1352)

Author Affiliations
From the Departments of Surgery (Dr Davis) and Pathology (Drs Chadburn and Mouradian), Cornell University Medical College, New York.

Footnotes
Accepted for publication June 21, 1988.

Read before the Eighth Annual Meeting of the Surgical Infection Society, San Francisco, May 5, 1988.

Reprint requests to Department of Surgery, Cornell University Medical College, 1300 York Ave, New York, NY 10021 (Dr Davis).

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