To compare the imaging characteristics of computed tomography (CT) and magnetic resonance imaging (MR) of acquired immune deficiency syndrome (AIDS) associated lymphoma (ARL) with different pathological types.

Patients with ARL were collected from Beijing Ditan Hospital, Capital Medical University from January 1st, 2008 to October 1st, 2018. The clinical data and imaging data were analyzed by cross-sectional investigation, retrospectively. Diagnosis is confirmed by puncture or surgery.

A total of 83 cases with ARL were collected, including 48 cases (57.8%) with diffused large B cell lymphoma (DLBCL) [(17 cases unclassified, 18 cases with germinal center (GC), 13 cases with non-germinal center (NGC)]. There were 23 cases (27.7%) with Burkitt lymphoma (BL) and 12 cases (14.5%) with other rare types of lymphoma. Patients were divided into three groups according to pathological types: DLBCL group, BL group and other types group. The median CD4⁺ T cell count of patients in BL group was 201 cells/μl, which was significantly higher than that of DLBCL group (78 cells/μl) and other types (74 cells/μl) (χ² = 6.603, P = 0.037). There was no significant difference among the patients with different pathological types in viral load of HIV (χ² = 0.396, P = 0.820), AIDS course (F = 1.342, P = 0.267) and whether or not taking ART therapy (χ² = 3.084, P = 0.544). Lymph node and cerebral forms of ARL was the most common, followed by digestive tracts (stomach and small intestine) and liver, but there was no significant difference among patients with different pathological types (χ² = 0.083, P = 0.959). Nodules or masses were the main forms in lymph node, and head lesions were ring enhancement. "Pseudoaneurysm like" dilatation was seen in digestive tract without intestinal obstruction, while parenchymal visceral lesions were not accompanied by vascular invasion and tumor embolus. According to Ann Arbor 4-stage classification: there were 20 cases (31.7%) of Ann Arbor stage 1, 14 cases (22.2%) of stage 2, 8 cases (12.7%) of stage 3, 21 cases (33.3%) of stage 4. There was no significant difference in Ann Arbor scores between patients with different pathological types (χ² = 4.948, P = 0.547). The number of patients with Ki67(+) ≥ 90% in DLBCL group (8 cases, 21.1%) and BL group (12 cases, 31.6%) were significantly higher than that of other groups (χ² = 6.016, P = 0.049). There was no significant difference in Ki67 positive ratio between DLBCL group and BL group (χ² = 2.440, P = 0.118). There was no correlation between the positive rate of Ki67 with tumor necrosis and tumor size (Spearman correlation coefficient R = 0.224, 0.059; P = 0.199, 0.857).

The imaging findings of different pathological types of ARL are similar and the positive rate of Ki67 could not predict the size and necrotic extent of the tumor.