A 33-year old man with acquired immunodeficiency syndrome was admitted to Severance hospital following 1 year of diarrhea and 2 to 3 months of low sternal pain. The patient had progressive generalized lymphadenopathy for the previous 3 years. Whole body bone scan for evaluation of bone pain showed multiple abnormal hot uptakes at the low sternal body and T8 and T10 vertebra. Chest CT showed multifocal cortical erosion of the bone with soft tissue mass at the low sternal body and spine MRI showed multiple low-signal density in T1WI and high-signal density in T2WI at the T8 and T10 vertebral body. Biopsy was performed at the sternochondral junction and it showed high-grade malignant lymphoma of the large cell immunoblastic type. Immunostaining showed positive for the B-cell markers (CD79a and L26) and negative for the T-cell marker (UCHL1). Radiotherapy of 3,000 cGy was delivered to the sternum and vertebra. Since then, systemic chemotherapy with m-BACOD regimen (except dexamethasone) and anti-retroviral therapy with a combination of 3 drugs (didanosine, lamivudine, indinavir) has been performed. This is the first case report of primary bone lymphoma associated with acquired immunodeficiency syndrome in Korea.
Adult ; Bone Neoplasms/therapy* ; Bone Neoplasms/diagnosis ; Case Report ; Combined Modality Therapy ; Human ; Lymphoma, AIDS-Related/therapy* ; Lymphoma, AIDS-Related/diagnosis ; Male

Non-Hodgkin's lymphoma (NHL) is the secondary most common tumor in HIV-infected individuals. The AIDS-related lymphomas are a late manifestation of HIV infection and may increase in frequency as patients live longer with highly active antiretroviral therapy and effective prophylaxis of opportunistic infections. Histologically AIDS-related NHL are either high (2/3) or intermediate (1/3) grade lymphoma. We report a case of gastric Non-Hodgkin's lymphoma in AIDS patient. Two years ago, she was diagnosed as HIV-infected individual in public hospital. She presented with epigastric pain and mass-like sensation. Under the impression of gastric cancer, subtotal gastrectomy was done. But, she diagnosed as diffuse large B cell lymphoma by histologic finding, immunohistochemical study. This is the first report of gastric Non-Hodgkin's lymphoma from AIDS patients in Korea.
Antiretroviral Therapy, Highly Active ; Gastrectomy ; HIV ; HIV Infections ; Hospitals, Public ; Humans ; Korea ; Lymphoma ; Lymphoma, AIDS-Related ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin* ; Opportunistic Infections ; Sensation ; Stomach Neoplasms

Diffuse large B cell lymphoma (DLBCL) is one of the most common acquired immune deficiency syndrome (AIDS)-defining malignancies among human immunodeficiency virus-infected patients, and rectal cancer has recently emerged as a prevalent non-AIDS-defining malignancy. We report a case of rectal squamous cell carcinoma that was metachronous with DLBCL in an HIV-infected patient who was receiving highly active antiretroviral therapy. The patient was diagnosed with DLBCL and showed complete remission after chemotherapy. Follow-up imaging showed increased uptake at the rectum, previously treated as lymphoma. Repeated biopsy was performed and squamous cell carcinoma of the rectum was reported. After concurrent chemoradiation therapy, curative resection was performed.
Acquired Immunodeficiency Syndrome ; Antiretroviral Therapy, Highly Active ; Biopsy ; Carcinoma, Squamous Cell* ; Drug Therapy ; Follow-Up Studies ; HIV ; Humans ; Lymphoma ; Lymphoma, AIDS-Related ; Lymphoma, B-Cell* ; Oncogenic Viruses ; Rectal Neoplasms ; Rectum

Acquired Immunodeficiency Syndrome ; drug therapy ; genetics ; surgery ; Adult ; Burkitt Lymphoma ; drug therapy ; genetics ; surgery ; virology ; Diagnosis, Differential ; Female ; Genes, myc ; HIV ; isolation & purification ; HIV Infections ; Herpesvirus 4, Human ; genetics ; Humans ; Immunohistochemistry ; Lymphoma, AIDS-Related ; drug therapy ; genetics ; surgery ; virology ; Lymphoma, B-Cell ; pathology ; Lymphoma, Mantle-Cell ; pathology ; Male ; Middle Aged ; RNA, Viral ; analysis ; Sarcoma, Myeloid ; pathology ; Translocation, Genetic

We evaluated risk factors for neutropenic fever and febrile prolonged neutropenia during vincristine-including chemotherapy to treat HIV-related lymphoma to investigate whether protease inhibitor (PI) treatment is associated with infectious complications due to drug interactions with chemotherapeutic agents. We included all HIV patients who received chemotherapy including vincristine for lymphoma at a single referral center in 1999-2010. Neutropenic fever was defined as absolute neutrophil count < 500 cells/microL with body temperature over 38degrees C; and prolonged neutropenia was defined if it persisted over 7 days. CODOX-M/IVAC and Stanford regimens were considered high-risk regimens for prolonged neutropenia. We analyzed 48 cycles of chemotherapy in 17 HIV patients with lymphoma. There were 22 neutropenic fever and 12 febrile prolonged neutropenia events. In multivariate analysis, neutropenic fever was associated with old age and low CD4 cell count, but not with PI use or ritonavir-boosted PI use. Low CD4 cell count and high-risk regimens were associated with febrile prolonged neutropenia. Neutropenic fever and febrile prolonged neutropenia is associated with old age, low CD4 cell count, and high-risk regimens, but not PI use, in HIV patients undergoing chemotherapy including vincristine for lymphoma.
Adult ; Age Factors ; Antineoplastic Agents, Phytogenic/*therapeutic use ; Body Temperature ; CD4 Lymphocyte Count ; Fever/*etiology ; HIV Infections/complications ; Humans ; Lymphoma, AIDS-Related/complications/*drug therapy/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neutropenia/*etiology ; Retrospective Studies ; Risk Factors ; Vincristine/*therapeutic use

Human immunodeficiency virus (HIV) infection is a risk factor for developing non-Hodgkin's lymphoma. Most acquired immune deficiency syndrome (AIDS)-related lymphomas are high-grade B cell non-Hodgkin's lymphomas. The use of highly active antiretroviral therapy has reduced the incidence of AIDS-related lymphoma. There have been 7 reports of AIDS-related extra-nodal lymphoma in Korea. We report a case of AIDS-related lymphoma detected by MiroCam(R) capsule endoscopy.
Acquired Immunodeficiency Syndrome/*complications/drug therapy/immunology ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; *Capsule Endoscopes ; HIV Infections/virology ; Humans ; Jejunal Neoplasms/*diagnosis/pathology ; Lymphoma, AIDS-Related/*diagnosis/pathology ; Lymphoma, Large B-Cell, Diffuse/immunology/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed