HIV 感染伴免疫重建患者的原发性胸壁 Burkitt 淋巴瘤
Primary chest wall Burkitt lymphoma in a case of HIV infection with immune reconstitution.
机构信息
Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Department of Internal Medicine, Armed Forces Medical College, Pune, India.
出版信息
BMJ Case Rep. 2021 Dec 30;14(12):e243873. doi: 10.1136/bcr-2021-243873.
Burkitt lymphoma (BL) develops at an increased frequency in patients with HIV irrespective of the CD4 count. Lymph nodes and gastrointestinal tract are common sites of involvement by BL; however, primary chest wall BL is rare. A 52-year-old man on highly active antiretroviral therapy (HAART) for HIV with a CD4 count of 0.204 x 10 cells/L presented with a 3-month history of enlarging chest wall mass. PET-CT scan imaging showed a bulky mass involving the musculoskeletal planes of left chest wall with the involvement of underlying pleura. Biopsy with immunohistochemistry confirmed BL. Patient received EPOCH-R (infusional etoposide, vincristine, and doxorubicin with prednisone, cyclophosphamide and rituximab) regime for six cycles along with HAART, attained complete remission (CR) and remains free of BL at 5 years. BL should be considered in the differential diagnosis of soft tissue masses in HIV-infected patients irrespective of their CD4 count.
伯基特淋巴瘤（BL）在 HIV 患者中的发病率增加，与 CD4 计数无关。淋巴结和胃肠道是 BL 常见的受累部位；然而，原发性胸壁 BL 较为罕见。一名 52 岁男性因 HIV 接受高效抗逆转录病毒治疗（HAART），CD4 计数为 0.204 x 10 个细胞/L，有 3 个月的胸壁肿块增大病史。PET-CT 扫描显示左胸壁肌骨平面有一个大肿块，累及胸膜下。免疫组化活检证实为 BL。患者接受了六个周期的 EPOCH-R（输注依托泊苷、长春新碱和多柔比星，联合泼尼松、环磷酰胺和利妥昔单抗）方案治疗，同时接受了 HAART，达到完全缓解（CR），至今 5 年仍未出现 BL。在 HIV 感染者中，无论 CD4 计数如何，均应考虑软组织肿块的鉴别诊断。
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