Right upper quadrant pain and mass in a 41-year-old previously healthy man: a presenting feature of HIV-associated extranodal diffuse large B cell lymphoma with cardiac involvement

With an increasing pandemic of HIV/AIDS, the incidence of HIV-associated lymphoma is expected to rise. Here, the authors report a case of a 41-year-old man who presented with right upper quadrant pain and mass, and was subsequently diagnosed with HIV-associated diffuse large B cell lymphoma (DLBCL) with cardiac involvement. This case illustrates some of the uncommon and interesting aspects of DLBCL: primary extramedullary extranodal stage IV disease as the presenting feature; cardiac involvement at presentation; DLBCL as the only clue to the diagnosis of HIV; and management of HIV-associated DLBCL. This case is also a reminder of the importance of the routine HIV screening for all patients between the ages of 13–64 years, as advocated by centres of disease control and prevention.

[1]  R. Gascoyne,et al.  Prognostic implications of extranodal involvement in patients with diffuse large B-cell lymphoma treated with rituximab and cyclophosphamide, doxorubicin, vincristine, and prednisone , 2010, Leukemia & lymphoma.

[2]  E. Giné,et al.  Clinico-biological characterization and outcome of primary nodal and extranodal diffuse large B-cell lymphoma in the rituximab era , 2010, Leukemia & lymphoma.

[3]  G. Pinkus,et al.  Primary Cardiac Lymphoma: Clinical, Histologic, Immunophenotypic, and Genotypic Features of 5 Cases of a Rare Disorder , 2007, The American journal of surgical pathology.

[4]  M. Horie,et al.  Primary malignant lymphoma of the right atrium resulting in superior vena caval syndrome in an HIV-positive patient: depiction at multislice computed tomography and magnetic resonance imaging. , 2006, Cardiovascular revascularization medicine : including molecular interventions.

[5]  T. Shenkier Chapter 18 – Primary Extranodal Non-Hodgkin's Lymphomas , 2006 .

[6]  D. Weisenburger,et al.  Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. , 2006, Blood.

[7]  J. Mate,et al.  The prognosis of HIV-infected patients with diffuse large B-cell lymphoma treated with chemotherapy and highly active antiretroviral therapy is similar to that of HIV-negative patients receiving chemotherapy. , 2005, Haematologica.

[8]  B. Christensen,et al.  Diffuse large B‐cell lymphoma: clinical implications of extranodal versus nodal presentation – a population‐based study of 1575 cases , 2004, British journal of haematology.

[9]  L. Dal Maso,et al.  Impact of concomitant antiblastic chemotherapy and highly active antiretroviral therapy on human immunodeficiency virus (HIV) viremia and genotyping in HIV-infected patients with non-Hodgkin lymphoma. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  R. Talamini,et al.  Concomitant cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy plus highly active antiretroviral therapy in patients with human immunodeficiency virus‐related, non‐Hodgkin lymphoma , 2001, Cancer.

[11]  F. Cavalli,et al.  Primary extranodal non-Hodgkin's lymphomas. Part 1: Gastrointestinal, cutaneous and genitourinary lymphomas. , 1997, Annals of oncology : official journal of the European Society for Medical Oncology.

[12]  L. Kaplan,et al.  Diagnosis and management of systemic non-Hodgkin's lymphoma in HIV disease. , 1996, Hematology/oncology clinics of North America.

[13]  A. Chan,et al.  Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. , 1993, Archives of pathology & laboratory medicine.

[14]  A. Holladay,et al.  Cardiac malignant lymphoma in acquired immune deficiency syndrome , 1992, Cancer.

[15]  C. Smith,et al.  Tumors of the heart. , 1986, Archives of pathology & laboratory medicine.