title: Right iliac fossa lymphoma in an HIV positive patient: A diagnostic dilemma.
abstract: Lymphoma should be considered early in patients with HIV when there is a history of weight loss. Although B-cell lymphoma is an AIDS-defining cancer, and many reports of lymphoma in HIV positive patients exist in the literature, this case report illustrates that even in patients with well-controlled HIV the diagnosis must be considered, and puts forward an unusual presentation in an otherwise asymptomatic patient. A 52 year old woman presented for a routine HIV follow-up appointment and was found to be experiencing weight loss. An abdominal examination revealed a right iliac fossa mass. Subsequent CT thorax, abdomen, pelvis imaging confirmed a large mass but did not allow determination of the primary source. Serological tumour marker investigations were unyielding. Trans-vaginal ultrasound guided biopsy of the mass demonstrated diffuse large B-cell lymphoma. This case report emphasises the importance of having a high index of suspicion for these cancers even in patients with low viral load who are on anti-retroviral treatment. It also demonstrates the importance of taking a multidisciplinary approach to diagnosis of the condition to enable prompt treatment and thus improve the outcome for the patient.
authors.affiliation: Conquest Hospital, St Leonard's Road, Hastings, East Sussex, United Kingdom.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sinnott
authors.affiliation: Conquest Hospital, St Leonard's Road, Hastings, East Sussex, United Kingdom.
authors.forename: Danial
authors.initials: D
authors.lastname: Natin
authors.affiliation: Eastbourne District General Hospital, King's Drive, East Sussex, United Kingdom. Electronic address: pkm.foster@doctors.org.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Foster
keywords: Case report; Diagnostics; HIV; Lymphoma