Harada Guilherme, Felipe-Silva Aloísio, Nogueira da Silva José Guilherme
Department of Internal Medicine - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil.
Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.
Autops Case Rep. 2014 Jun 30;4(2):49-54. doi: 10.4322/acr.2014.014. eCollection 2014 Apr-Jun.
HIV infection is known to be associated with the development of a wide range of neoplasia. About 25 to 40% of HIV-positive patients will present some kind of malignancy in the course of the disease; among them 10% are non-Hodgkin lymphomas (NHL) and 20% of these are represented by the diffuse large B-cell lymphoma. HIV-positive patients have a relative risk of 110 times higher to develop neoplasia, than the non-infected population. The gastrointestinal (GI) tract is the most frequent extranodal site of involvement. However, the primary GI lymphoma is rare. The authors present a case of a 31-year-old male patient with a 16-year history of HIV infection, who deliberately withdrew the Highly Active Antiretroviral Therapy (HAART) regimen and was hospitalized because of a respiratory infection. Because of a long-term complaint of dyspepsia, an upper gastrointestinal endoscopy was performed disclosing a large elevated and ulcerated gastric lesion, which biopsy revealed a diffuse large B-cell lymphoma. Clinical, imaging and laboratory tests showed an early stage diagnosis: Lugano stage I. Although not frequent, the authors alert to considering this neoplasia in all HIV-positive patients with dyspeptic symptoms.
已知HIV感染与多种肿瘤的发生有关。约25%至40%的HIV阳性患者在病程中会出现某种恶性肿瘤；其中10%是非霍奇金淋巴瘤（NHL），而这些患者中有20%表现为弥漫性大B细胞淋巴瘤。HIV阳性患者发生肿瘤的相对风险比未感染人群高110倍。胃肠道（GI）是最常受累的结外部位。然而，原发性胃肠道淋巴瘤很少见。作者报告了一例31岁男性患者，有16年HIV感染史，他故意停用了高效抗逆转录病毒治疗（HAART）方案，因呼吸道感染住院。由于长期消化不良主诉，进行了上消化道内镜检查，发现一个大的隆起且溃疡的胃部病变，活检显示为弥漫性大B细胞淋巴瘤。临床、影像学和实验室检查显示为早期诊断：卢加诺I期。尽管不常见，但作者提醒，对于所有有消化不良症状的HIV阳性患者，都应考虑这种肿瘤。
