Castillo Jorge J, Rizack Tina, Treaba Diana
Division of Hematology and Oncology, The Miriam Hospital, The Warren Alpert Medical School of Brown University, 164 Summit Avenue, Providence, RI 02906, USA.
Patholog Res Int. 2010 Oct 5;2011:563216. doi: 10.4061/2011/563216.
Patients with HIV/AIDS have a higher risk of developing aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma (DLBCL). Lymphomas are rather heterogeneous in nature and in a few cases can switch their genetic or immunohistochemical phenotype, transform into other lymphomas or carry more than one malignant clone. In this report, we present the case of a 47-year-old man with HIV infection who was diagnosed with an apparent low-risk, early-stage DLBCL, but became refractory to therapy while undergoing treatment with rituximab-containing chemotherapy. We postulate that the development of his refractory disease occurred in the context of an immunohistochemical switch or the surge of a clone refractory to therapy. This phenomenon was not associated with a superinfection with EBV or HHV-8.
感染人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）的患者发生侵袭性B细胞淋巴瘤的风险更高，如弥漫性大B细胞淋巴瘤（DLBCL）。淋巴瘤本质上具有相当大的异质性，在少数情况下可改变其基因或免疫组化表型，转化为其他淋巴瘤或携带不止一个恶性克隆。在本报告中，我们介绍了一名47岁HIV感染男性的病例，他被诊断为明显低风险的早期DLBCL，但在接受含利妥昔单抗的化疗时对治疗产生了耐药性。我们推测，他的难治性疾病是在免疫组化转换或对治疗耐药的克隆激增的背景下发生的。这种现象与EB病毒（EBV）或人疱疹病毒8型（HHV-8）的重叠感染无关。
