title: Development of primary central nervous system lymphoma associated with human immunodeficiency virus and JC virus infection.
abstract: We report here a case of a 37-year-old man with human immunodeficiency virus (HIV) infection followed by JC virus (JCV) infection and primary central nervous system lymphoma (PCNSL). The patient had been infected with HIV type 1 due to blood products for hemophilia A during infancy. He had progression of nervous symptoms and was diagnosed with progressive multifocal leukoencephalopathy (PML) clinically at the age of 36, when his CD4-positive lymphocyte counts ranged between 350 and 450/μl. Oral mefloquine, intravenous methylprednisolone pulse therapy, and intravenous immunoglobulin were not effective for the PML, and the patient entered a vegetative state. Brain biopsy revealed JCV infection without pathological findings of PML. Eight months after the clinical diagnosis of PML, he developed respiratory failure and brain magnetic resonance imaging revealed a mass lesion in the brain stem. The patient died 19 months after the diagnosis of PML. Autopsy findings were compatible with PCNSL. EBV-encoded small RNA-1-positive cells were not detected. We present a case of JCV-positive PCNSL with HIV infection complicated with clinical PML.
authors.affiliation: Department of Hematology, NHO Matsumoto Medical Center.
authors.forename: Toru
authors.initials: T
authors.lastname: Kawakami
authors.forename: Kaoko
authors.initials: K
authors.lastname: Sakai
authors.forename: Yuto
authors.initials: Y
authors.lastname: Mimura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Senoo
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakazawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koshihara
authors.forename: Kenya
authors.initials: K
authors.lastname: Oguchi
authors.forename: Yo-ichi
authors.initials: Y
authors.lastname: Takei
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohara
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Watanabe
authors.forename: Kou
authors.initials: K
authors.lastname: Nakazawa
authors.forename: Kiyomitsu
authors.initials: K
authors.lastname: Oyanagi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kitano
mesh_terms: D000328:Adult; D002493:Central Nervous System Diseases / Q000473:pathology / Q000821:virology*; D015658:HIV Infections / Q000473:pathology* / Q000821:virology*; D006801:Humans; D007577:JC Virus / Q000302:isolation & purification*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000473:pathology* / Q000821:virology*; D008223:Lymphoma / Q000473:pathology / Q000821:virology*; D008297:Male