Department of Internal Medicine, Northeast Georgia Medical Center, Gainesville, GA, USA.
Department of Infectious Diseases, Northeast Georgia Medical Center, Gainesville, GA, USA.
Am J Case Rep. 2022 May 15;23:e936267. doi: 10.12659/AJCR.936267.
BACKGROUND Recent reports have shown an increased incidence of Hodgkin lymphoma (HL) in patients treated with antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection. This report is of a case of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) with a good outcome in a 58-year-old Nigerian HIV-positive man who was being treated with ART. CASE REPORT A 58-year-old HIV-positive man presented to a clinic for evaluation of a left axillary mass. He was diagnosed with HIV in 2005, which was well-controlled by ART. He reported intermittent swelling in the left axillary region for several years. Results of a physical examination were significant for mild tender left anterior axillary lymphadenopathy. He had a computed tomography (CT) scan of the chest and neck, which showed left axillary adenopathy, with the largest measuring 3.5×2.0 cm. A staging positron emission tomography-computed tomography (PET/CT) showed focal uptake in 2 left axillary lymph nodes with no other sites involved. He underwent excision of the left axillary lymph node. Histopathology was consistent with nodular lymphocyte-predominant-type Hodgkin's lymphoma (NLHPL). He underwent radiation therapy with a total dose of 3600 centigray (cGy) according to National Comprehensive Cancer Network (NCCN) guidelines. The 5-month follow-up PET/CT scan showed no evidence of malignancy. CONCLUSIONS We present a case of HIV-associated NLHPL that had an indolent course and a good treatment outcome. This case highlights the importance of regular physical examination in HIV patients while on treatment with ART and accurate diagnosis of the cause of lymphadenopathy to prevent extra-nodal spread in cases of lymphoma.
最近的报告显示，接受抗逆转录病毒疗法（ART）治疗人类免疫缺陷病毒（HIV）感染的患者中霍奇金淋巴瘤（HL）的发病率增加。本报告介绍了 1 例 58 岁尼日利亚 HIV 阳性男性患者，在接受 ART 治疗期间发生结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL），结局良好。
1 例 58 岁 HIV 阳性男性患者因左侧腋窝肿块就诊。他于 2005 年被诊断为 HIV，通过 ART 得到了很好的控制。他报告说，左侧腋窝区域间歇性肿胀已有数年。体格检查结果显示，左侧前腋窝轻度触痛的淋巴结肿大。他进行了胸部和颈部的计算机断层扫描（CT），显示左侧腋窝淋巴结病，最大的淋巴结为 3.5×2.0cm。分期正电子发射断层扫描-计算机断层扫描（PET/CT）显示 2 个左侧腋窝淋巴结有局灶摄取，无其他部位受累。他接受了左侧腋窝淋巴结切除术。组织病理学与结节性淋巴细胞为主型霍奇金淋巴瘤（NLHPL）一致。根据国家综合癌症网络（NCCN）指南，他接受了总剂量为 3600 厘戈（cGy）的放射治疗。5 个月的随访 PET/CT 扫描显示无恶性肿瘤证据。
我们报告了 1 例 HIV 相关 NLHPL，其病程呈惰性，治疗结局良好。该病例强调了在接受 ART 治疗的 HIV 患者中定期进行体格检查以及准确诊断淋巴结病原因的重要性，以防止淋巴瘤病例发生淋巴结外扩散。
