Tao Peng Fei, Lou Jincheng, Wang Xicheng
Department of Infectious Disease, Yun nan Provincial Infectious Disease Hospital, 650301, China.
Leuk Res Rep. 2025 Aug 25;24:100540. doi: 10.1016/j.lrr.2025.100540. eCollection 2025.
Acquired Immunodeficiency Syndrome (AIDS)-related lymphoma has diverse clinical manifestations, and its diagnosis is often challenging. Misdiagnosis can delay treatment and affect patient prognosis. We assessed the clinical data of eight patients with atypical clinical manifestations of AIDS-related lymphoma, to enhance physicians' understanding of these patients, and reduce the potential for misdiagnosis.
A retrospective analysis was conducted on eight patients with atypical manifestations of AIDS-related lymphoma admitted to the Department of Infectious Diseases of Yunnan Provincial Hospital between May 2017 and May 2023. They were initially misdiagnosed with opportunistic infections, and were later diagnosed with lymphoma.
The patients comprised five males and three females. Cluster of Differentiation 4 (CD) counts were lower than 200/μl for all patients, and inflammatory marker levels were elevated to varying degrees. Four patients had recurrent fever, one had bleeding, one had pulmonary infection, one had long-term diarrhoea, and one had visual impairment as the primary symptoms. Six patients were diagnosed through bone marrow cytology and biopsy, one through colonoscopy and pathological biopsy, and one through computed tomography-guided percutaneous lung biopsy. All patients had extranodal involvement, including one case in the intestine, one in the lung, and six in the bone marrow. All patients were at lymphoma stage IV, with four in Group A and four in group B.
In patients with AIDS, particularly those with low CD4 counts and unexplained fever, atypical lymphoma should be considered, and tissue biopsy should be performed to further confirm the diagnosis.
获得性免疫缺陷综合征(AIDS)相关淋巴瘤临床表现多样,诊断常具有挑战性。误诊会延误治疗并影响患者预后。我们评估了8例AIDS相关淋巴瘤非典型临床表现患者的临床资料,以提高医生对这些患者的认识,并降低误诊可能性。
对2017年5月至2023年5月间云南省医院感染科收治的8例AIDS相关淋巴瘤非典型表现患者进行回顾性分析。他们最初被误诊为机会性感染,后来被诊断为淋巴瘤。
患者包括5名男性和3名女性。所有患者的分化簇4(CD)计数均低于200/μl,炎症标志物水平不同程度升高。4例患者以反复发热为主要症状,1例有出血表现,1例有肺部感染,1例长期腹泻,1例以视力障碍为主要症状。6例通过骨髓细胞学和活检确诊,1例通过结肠镜检查及病理活检确诊,1例通过计算机断层扫描引导下经皮肺穿刺活检确诊。所有患者均有结外受累,其中肠道1例,肺部1例,骨髓6例。所有患者均处于淋巴瘤IV期,A组4例,B组4例。
对于AIDS患者,尤其是CD4计数低且有不明原因发热的患者,应考虑非典型淋巴瘤,需进行组织活检以进一步确诊。