The case of a diffuse large B-cell lymphoma (DLBCL) in a course of HIV

SummaryBackgroundLymphomas develop in approximately 6% of HIV-positive patients, who are estimated to have a 100-200-fold higher risk of lymphoma and as much as a 1000-fold higher risk of primary cerebral lymphoma.Case ReportPatient T.R., age 33, HIV positive – diagnosis 3 years before, CD4 = 120/ul, he didn't agree to continue HAART. Two months before present hospitalization developed an enlarged lymph node in the left axilla, substantially increased in diameter reaching 12 cm, and an infiltration of the chest skin. The enlarged lymph node was sampled, and in a microscopic evaluation it was diagnosed as diffuse large B-cell lymphoma (DLBCL). After establishing the diagnosis, the patient received antiretroviral therapy (tenofovir, lamivudine, lopinavir, ritonavir) and courses of chemotherapy according to the CHOP regimen (cyclophosphamide, vincristine, doxorubicin, prednisone) combined with rituximab. The treatment resulted in a marked local tumor regression in the chest and left axilla. During the lymphoma therapy numerous complications were observed. Psychologically, the patient was very optimistic until the last chemotherapy cycle. He died after the fifth cycle.ConclusionThe decision to start chemotherapy and HAART should be taken individually for every patient. Unfortunately, despite the recent advances in therapy, the prognosis in HIV-positive patients with lymphomas remain poor.