Cutaneous lesions as the first manifestation of systemic follicular lymphoma in an HIV patient.
Human immunodeficiency virus (HIV) patients have an increased incidence of lymphomas, particularly when there is a significant immunosuppression. Most commonly, they are non-Hodgkin B cell type with a high or intermediate grade and have an extranodal presentation. We report the case of a 38-year-old man with HIV infection who presented with a 1-year history of a painless tumor on the back and lymphadenopathies. The diagnosis of B cell lymphoma follicle center cell type was established by skin biopsy. Staging included a bone marrow biopsy revealing infiltration by the lymphoma and a whole-body computed tomographic scan showing multiple cervical and axillary lymphadenopathies with necrotic center. Biopsy of an axillary lymph node revealed caseating epithelioid granulomas and Ziehl-Neelson staining was positive for acid-fast bacilli. The patient started therapy for tuberculosis and polychemotherapy for lymphoma with complete response. This report illustrates a case of simultaneous occurrence of tuberculosis and systemic follicular lymphoma presenting in skin in an HIV patient.
Moreira
Elisabete
E
Department of Dermatovenereology, Hospital S João, Porto, Portugal. elisabetedosmoreira@gmail.com
Lisboa
Carmen
C
Alves
Sérgio
S
Moreira
Ilídia Ilídia
II
Fonseca
Elsa
E
Azevedo
Filomena
F
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008206:Lymphatic Diseases / Q000473:pathology; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014382:Tuberculosis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*
D000970:Antineoplastic Agents