Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, ROC.
J Microbiol Immunol Infect. 2013 Jun;46(3):234-6. doi: 10.1016/j.jmii.2012.01.014. Epub 2012 Apr 12.
A 36-year-old man was diagnosed with plasma-cell type Castleman's disease with the presentation of recurrent lymphadenpathy of the neck. HIV infection was not suspected or confirmed until esophageal candidiasis developed one year later. Meanwhile, surgery was performed for intestinal intussusception and obstruction caused by lymphocyte-depletion Hodgkin lymphoma. However, he died of rapidly progressive pneumonia and disseminated intravascular coagulation associated with intracerebral hemorrhage, which occurred 6 months later during the course of chemotherapy. This case suggests that HIV infection should be considered in patients who present with plasma-cell type Castleman's disease or lymphocyte-depletion Hodgkin lymphoma with extra-nodal involvement in order to conduct appropriate diagnosis and initiate treatment for HIV infection.
一位 36 岁男性因颈部反复淋巴结病被诊断为浆细胞型 Castleman 病。直到一年后出现食管念珠菌病,才怀疑或确诊感染 HIV。同时,因淋巴细胞耗竭型霍奇金淋巴瘤导致肠套叠和梗阻而行手术治疗。然而,他在化疗过程中 6 个月后因与脑出血相关的进行性肺炎和弥漫性血管内凝血而死亡。本病例提示,对于出现浆细胞型 Castleman 病或伴有结外累及的淋巴细胞耗竭型霍奇金淋巴瘤的患者,应考虑 HIV 感染,以便进行适当的诊断和启动 HIV 感染的治疗。