Non-Hodgkin lymphoma of bone in an HIV-infected patient from Argentina

Uriel Sandkovsky,Emiliano Bissio,Pablo Fernando Martin

doi:10.3855/jidc.1868

Abstract

Human immunodeficiency virus (HIV)-infected patients are at higher risk for development of Non-Hodgkin's lymphoma (NHL). The estimated incidence of NHL in patients with acquired immunodeficiency syndrome (AIDS) is much higher when compared to the general population. Most AIDS-associated NHL are of intermediate- or high-grade B-cell type and involve extranodal sites more frequently. The most common sites are the central nervous system (CNS), gastrointestinal tract, liver, bone marrow and soft tissues. We describe a 42-year-old male with risk factors for HIV infection who presented with left leg pain and an osteolytic lesion of the left medial tibia. He was subsequently diagnosed with HIV disease and an open biopsy of his left tibia established the diagnosis of NHL. After starting antiretroviral therapy followed by chemotherapy he achieved remission. Bone lymphomas account for 3% of malignant bone tumors and 4-7% of all extranodal sites. NHL of bone has been infrequently described in patients with AIDS. To our knowledge, this is the first report of NHL of the bone in Argentina.

Highlights

Human immunodeficiency virus (HIV)-infected patients are at higher risk for development of Non-Hodgkin’s lymphoma (NHL)
acquired immunodeficiency syndrome (AIDS)-related lymphomas can be subdivided based on World Health Organization (WHO) criteria into 3 categories: 1) lymphomas that occur in immunocompetent patients such as Burkitt’s lymphoma, diffuse large B-cell lymphoma, Extranodal Marginal zone B-cell lymphoma and peripheral T-cell lymphoma; 2) lymphomas that occur more frequently in patients with HIV disease, such as plasmablastic lymphoma and primary effusion lymphoma; 3) lymphomas that occur in other immunodeficiency states including posttransplant lymphoproliferative disorder-like B-Cell lymphoma
Most of AIDS-NHL share an aggressive course with extranodal disease and plasma cell differentiation [2]

Summary

Introduction

Human immunodeficiency virus (HIV)-infected patients are at higher risk for development of Non-Hodgkin’s lymphoma (NHL). Adverse prognostic criteria include ages greater than 35 years, history of intravenous drug abuse, CD4 counts less than 100 cells/μL, elevated serum LDH, advanced lymphoma stage, prior AIDS diagnosis and poor performance status [8].

Results

Conclusion