A 45-year-old man with HIV infection comes to the office because of a 6-week history of swelling near the left side of his neck. His most recent CD4+ T-lymphocyte count was 42/mm3 (N>500), and plasma HIV viral load was 55,000 copies/mL. He currently takes no medications. His temperature is 38oC (100oF), pulse is 72/min, respirations are 12/min and blood pressure is 120/81 mmHg. Physical examination shows a left supraclavicular mass. Immunohistochemical staining of a biopsy specimen of the mass confirms the presence of the causal virus’s DNA and replication within lymphoma cells but not in nearby normal cells. Which of the following is the most likely explanation for the tumor formation? a) Chronic immune activation of B lymphocytes b) Chronic immune activation of T lymphocytes c) Inhibition of B-lymphocyte tumor surveillance d) Inhibition of T-lymphocyte tumor surveillance e) Malignant transformation of B lymphocytes f) Malignant transformation of T lymphocytes

A 45-year-old man with HIV infection comes to the office because of a 6-week history of swelling near the left side of his neck. His most recent CD4+ T-lymphocyte count was 42/mm3 (N>500), and plasma HIV viral load was 55,000 copies/mL. He currently takes no medications. His temperature is 38oC (100oF), pulse is 72/min, respirations are 12/min and blood pressure is 120/81 mmHg. Physical examination shows a left supraclavicular mass. Immunohistochemical staining of a biopsy specimen of the mass confirms the presence of the causal virus’s DNA and replication within lymphoma cells but not in nearby normal cells. Which of the following is the most likely explanation for the tumor formation? a) Chronic immune activation of B lymphocytes b) Chronic immune activation of T lymphocytes c) Inhibition of B-lymphocyte tumor surveillance d) Inhibition of T-lymphocyte tumor surveillance e) Malignant transformation of B lymphocytes f) Malignant transformation of T lymphocytes