HIV-related Burkitt lymphoma with florid granulomatous reaction: an unusual case with good outcome.
Burkitt lymphoma (BL) is a highly aggressive subtype of non-Hodgkin lymphomas (NHL). Lymphoma related granulomatous reaction rarely occurs in sporadic BL. Herein, we describe the first case of HIV related Burkitt lymphoma with florid granulomatous reaction. A 41-year-old HIV-positive Chinese male presented lymphadenopathy in the right cervical region for 3 months. The enlarged lymph node biopsies revealed the presence of prominent granulomas of varying size with Langhans giant cells, leading to the misdiagnosis of tuberculous lymphadenitis in other hospital. Subsequently, the case was sent to us for consultation. The morphology, immunophenotype, special staining, interphase FISH analysis and blood tests confirmed a diagnosis of HIV related Burkitt lymphoma with granulomatous reaction. Without radiotherapy and chemotherapy, the patient was alive and well with no evidence of lymphoma during the observation period of 24 months. The case suggested that lymphoma with florid granulomatous reaction can easily be misdiagnosed as benign lesions since the large number of epithelioid granulomas could obscure the primary lesion. Moreover, the granulomatous reaction may be an indicator for favorable prognosis in HIV related Burkitt lymphoma.
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Jin-Nan
JN
Li
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Li-Min
LM
Gao
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Wei-Ya
WY
Wang
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Min
M
Chen
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Gan-Di
GD
Li
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Wei-Ping
WP
Liu
Department of Pathology, West China Hospital, Sichuan University Chengdu 610041, China.
Wen-Yan
WY
Zhang
D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D001706:Biopsy; D002051:Burkitt Lymphoma / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000601:surgery / Q000821:virology; D003951:Diagnostic Errors; D006099:Granuloma / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000601:surgery / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology* / Q000601:surgery / Q000821:virology; D008297:Male; D011237:Predictive Value of Tests; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis
D014408:Biomarkers, Tumor
Human immunodeficiency virus related Burkitt lymphoma; granulomatous reaction; prognosis