Early stage primary gastric diffuse large B-cell lymphoma in a young HIV-positive patient

Abstract

HIV infection is known to be associated with the development of a wide range of neoplasia. About 25 to 40% of HIV-positive patients will present some kind of malignancy in the course of the disease; among them 10% are non-Hodgkin lymphomas (NHL) and 20% of these are represented by the diffuse large B-cell lymphoma. HIV-positive patients have a relative risk of 110 times higher to develop neoplasia, than the non-infected population. The gastrointestinal (GI) tract is the most frequent extranodal site of involvement. However, the primary GI lymphoma is rare. The authors present a case of a 31-year-old male patient with a 16-year history of HIV infection, who deliberately withdrew the Highly Active Antiretroviral Therapy (HAART) regimen and was hospitalized because of a respiratory infection. Because of a long-term complaint of dyspepsia, an upper gastrointestinal endoscopy was performed disclosing a large elevated and ulcerated gastric lesion, which biopsy revealed a diffuse large B-cell lymphoma. Clinical, imaging and laboratory tests showed an early stage diagnosis: Lugano stage I. Although not frequent, the authors alert to considering this neoplasia in all HIV-positive patients with dyspeptic symptoms.

A Newly Diagnosed Patient With Human Immunodeficiency Virus (HIV)-Associated Epstein-Barr Virus (EBV)-Positive Diffuse Large B-cell Lymphoma and Esophageal Candidiasis: A Case Report

“…They represent a fraction (1-4%) of tumors found in the stomach, small intestine, and colon; the GI tract is affected secondarily in 10% of patients. The stomach is commonly affected, accounting for 68-75% of cases, followed by the small intestine (9%), ileocecal region (7%), and rectum (2%) [ 1 ].…”

“…Although gastrointestinal (GI) lymphomas are uncommon, these patients are more prone to non-Hodgkin lymphomas (NHL), including diffuse large B-cell lymphoma (DLBCL), the most common type seen in this group. In our case report, we are presenting a case of an HIV patient diagnosed with EBV DLBCL and esophageal candidiasis, highlighting the complexities of complications related to acquired immunodeficiency syndrome (AIDS) [ 1 - 4 ].…”

Primary pancreatic lymphoma: diagnostic pitfall of an uncommon medical entity mimicking operable pancreatic carcinoma: case report and review of literature

“…Primary G.I lymphoma are defined as lymphomas predominantly involving any section of GI tract from oropharynx to rectum where the disease typically involves a single primary site or multiple sites within GI tract. [5][6][7] (Table 1 for staging of primary gastrointestinal lymphoma).…”