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Hodgkin Lymphoma & Immunodeficiency: Immunodeficiency states increase the risk of developing classic Hodgkin lymphoma (cHL). HIV patients have a 6 to 20-fold increased risk. The features of cHL in patients with HIV include: advanced disease, involvement of unusual sites, frequent bone marrow infiltration, and unfavorable histologies such as mixed cellularity and lymphocyte depleted, and an aggressive clinical course. Most cases occurring in the setting of HIV are also associated with EBV. cHL develops within the first few months after initiation of anti-retroviral therapy.

Solid organ and allogeneic bone marrow transplant recipients show a delayed increase in the risk of developing cHL. Most cases are of mixed cellularity subtype and are EBV-driven. The clinical outcome is similar to that seen in non-immunocompromised patients.

About this Image: Classic Hodgkin lymphoma, nodular sclerosis, involving periaortic lymph nodes. Image courtesy of Dr. Jean-Christophe Fournet, Paris, France; humpath.com; Used with permission

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