Case Reports
Primary Mediastinal Large B-Cell Lymphoma in an HIV-Infected Patient

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ABSTRACT

HIV-related non-Hodgkin lymphoma is well documented in the literature. We report a case of an HIV-infected patient who presents with primary mediastinal large B-cell lymphoma. On review of the literature, this appears to be the first documented case of this subtype of large B-cell non-Hodgkin lymphoma seen in an HIV-infected patient. Our patient received CHOP (cyclophosphamide, hydroxydaunomycin, Oncovin, prednisone) chemotherapy with granulocyte colony-stimulating factor support but unfortunately died a few days later.

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Case Report

A 29-year-old woman known to be HIV infected for the past 12 years, without any prior AIDS-defining illness, presented to the infectious disease clinic for initiation of highly active antiretroviral therapy (HAART) with a CD4 count of 316 cells/μL and viral load of 12,983 copies/mL. Her primary care physician saw the patient a few weeks prior for fevers, night sweats, and cough and started her on co-trimoxazole for presumed Pneumocystis carinii pneumonia. The patient was started on efavirenz

Discussion

It is well documented in the literature that patients with HIV infection have a higher incidence of NHL as compared with the general population.1 In 1985, NHL became an AIDS-defining illness.4 The most commonly seen AIDS-related lymphomas are Burkitt lymphoma, diffuse large B-cell lymphoma, primary effusion lymphoma, and plasmablastic lymphoma of the oral cavity.5 HIV-related lymphomas are usually aggressive B-cell lymphomas, and patients suffering from HIV-related NHL tend to have lower

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