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艾滋病相关双打击弥漫性大B细胞淋巴瘤

Double-Hit Diffuse Large B-Cell Lymphoma in AIDS.

作者信息

S Subha Sree, Moorthy Swathy

机构信息

General Medicine, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

Internal Medicine, Sri Ramachandra Medical College, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.

出版信息

Cureus. 2024 Nov 7;16(11):e73190. doi: 10.7759/cureus.73190. eCollection 2024 Nov.

DOI:10.7759/cureus.73190
PMID:39651017
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11624958/
Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common type of immunoblastic lymphoma associated with AIDS, with the stomach being the most frequent extranodal site of involvement. Despite the widespread use of combined antiretroviral therapy (cART), the incidence of systemic lymphomas remains relatively high. These lymphomas often present in the early stages of AIDS as high-grade malignancies. We report the case of a man in his early 30s who initially presented with chronic cough and weight loss, diagnosed with pulmonary tuberculosis and found to be HIV-positive. Within a few months, he returned with persistent abdominal pain and progressive weight loss. Imaging revealed a gastric ulcer, and biopsy confirmed the diagnosis of DLBCL. Although cART is now available and started early upon an HIV diagnosis, vigilant surveillance, early diagnosis, and prompt initiation of chemotherapy are critical for achieving an adequate response and remission.

摘要

弥漫性大B细胞淋巴瘤（DLBCL）是与艾滋病相关的最常见的免疫母细胞淋巴瘤类型，胃部是最常受累的结外部位。尽管联合抗逆转录病毒疗法（cART）已广泛应用，但系统性淋巴瘤的发病率仍然相对较高。这些淋巴瘤在艾滋病早期常表现为高级别恶性肿瘤。我们报告一例30岁出头男性的病例，他最初表现为慢性咳嗽和体重减轻，被诊断为肺结核且发现HIV阳性。几个月内，他因持续腹痛和进行性体重减轻而复诊。影像学检查显示胃溃疡，活检确诊为DLBCL。尽管现在有cART且在HIV诊断后尽早开始使用，但严密监测、早期诊断以及及时启动化疗对于获得充分反应和缓解至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/4f02fe6745bc/cureus-0016-00000073190-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/756afc635dd3/cureus-0016-00000073190-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/ce9647f89005/cureus-0016-00000073190-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/7cdeb6b38862/cureus-0016-00000073190-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/05b7435d8833/cureus-0016-00000073190-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/fcd81e9e5c76/cureus-0016-00000073190-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/d90cacf2e76c/cureus-0016-00000073190-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/4f02fe6745bc/cureus-0016-00000073190-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/756afc635dd3/cureus-0016-00000073190-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/ce9647f89005/cureus-0016-00000073190-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/7cdeb6b38862/cureus-0016-00000073190-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/05b7435d8833/cureus-0016-00000073190-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/fcd81e9e5c76/cureus-0016-00000073190-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/d90cacf2e76c/cureus-0016-00000073190-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4844/11624958/4f02fe6745bc/cureus-0016-00000073190-i07.jpg

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本文引用的文献

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The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms.《世界卫生组织造血与淋巴组织肿瘤分类》第五版：淋巴肿瘤。
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Hematologic cancers in individuals infected by HIV.感染HIV的个体中的血液系统癌症。
Blood. 2022 Feb 17;139(7):995-1012. doi: 10.1182/blood.2020005469.
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