Peng Fei Tao, Ru Xi Hui, Hai Yan Min
Department of Infectious, Yunnan Provincial Infectious Diseases Hospital, Kunming 650301, China.
Department of Infectious, Baoshan People's Hospital, Baoshan, 678000, China.
Heliyon. 2023 Sep 12;9(9):e20073. doi: 10.1016/j.heliyon.2023.e20073. eCollection 2023 Sep.
Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive B-lymphocyte-derived malignant proliferative disease that is currently one of the leading causes of death in HIV patients. The incidence of lymphoma in HIV patients is 60-200 times higher than in the general population compared to the non-HIV population, and diffuse large B-cell lymphoma can cause numerous disease manifestations, especially in severely immunocompromised individuals. We treated a case of HIV-associated splenic diffuse large B-cell lymphoma combined with hepatitis C and tuberculous meningitis. In this case, diffuse large B-cell lymphoma of the spleen was difficult to diagnose. Second, simultaneous treatment of multiple diseases requires consideration of drug interactions. Our case highlights the diagnostic value of early tissue biopsy and the importance of avoiding drug interactions during treatment, and the selection of appropriate CART, anti-hepatitis C, and anti-tuberculosis protocols to reduce mortality from diffuse large B-cell lymphoma comorbidification.
弥漫性大B细胞淋巴瘤(DLBCL)是一种高度侵袭性的B淋巴细胞源性恶性增殖性疾病,目前是HIV患者主要的死亡原因之一。与非HIV人群相比,HIV患者淋巴瘤的发病率比普通人群高60 - 200倍,弥漫性大B细胞淋巴瘤可导致多种疾病表现,尤其是在严重免疫功能低下的个体中。我们治疗了1例合并丙型肝炎和结核性脑膜炎的HIV相关脾脏弥漫性大B细胞淋巴瘤病例。在此病例中,脾脏弥漫性大B细胞淋巴瘤难以诊断。其次,多种疾病的同时治疗需要考虑药物相互作用。我们的病例突出了早期组织活检的诊断价值以及治疗期间避免药物相互作用的重要性,以及选择合适的嵌合抗原受体T细胞(CART)、抗丙型肝炎和抗结核方案以降低弥漫性大B细胞淋巴瘤合并症死亡率的重要性。