Diffuse Large B-cell Lymphoma of the Ileum in a 41-year-old Greek Male with Undiagnosed HIV Infection Presenting with Iliac Fossa Pain

Abstract

The incidence of lymphoma in patients with HIV infection is higher than in the general population. Here, we present the case of a 41-year-old Greek male with recurrent episodes of fever for one year, who presented with the symptoms and signs of acute abdomen, right pelvic pain, anorexia and nausea starting 8 hours prior to admission. Laparotomy revealed complete obstruction of the terminal ileum and cecum due to a ruptured mass. A right colectomy with a latero-lateral ileotransverse anastomosis was performed. On histology, the mass proved to be an extranodal localization of diffuse large B-cell lymphoma (DLBCL) of the ileum. Based on the history and histopathological findings, HIV infection was suspected and testing proved positive. We hypothesize that although this patient had been suffering from intermittent fever for a year, he was never investigated thoroughly, and delay in the diagnosis and treatment of the HIV infection favored the development of lymphoma. All patients with lymphoma should be investigated for underlying immunosuppression, especially in the case of extranodal localization of the disease.