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Soft-tissue masses as presentation of non-Hodgkin's lymphoma in AIDS patients.

Corti M, Villafañe MF, Bistmans A, Campitelli A, Narbaitz M - An Bras Dermatol (2013 Jul-Aug)

Bottom Line: Generally, Non-Hodgkin lymphomas of the soft tissue present as large subcutaneous masses without evidence of nodal or skin involvement.We describe four cases of primary Non-Hodgkin lymphomas of the soft tissue in patients infected with the human immunodeficiency virus.Non-Hodgkin lymphomas should be included in the differential diagnosis of soft tissue masses in human immunodeficiency virus - seropositive patients.

View Article: PubMed Central - PubMed

Affiliation: HIV/AIDS Department, Infectious Diseases, F. J. Muñiz Hospital, Buenos Aires, Argentina.

ABSTRACT
Primary soft tissue Non-Hodgkin lymphomas are very rare and account only for 0.1 % of the cases. Generally, Non-Hodgkin lymphomas of the soft tissue present as large subcutaneous masses without evidence of nodal or skin involvement. We describe four cases of primary Non-Hodgkin lymphomas of the soft tissue in patients infected with the human immunodeficiency virus. The most common site of involvement was the chest wall in all the patients; histopathological and immunophenotypic examination of the biopsy smears revealed two cases of plasmablastic lymphomas, one Burkitt and one diffuse large B-cell lymphoma. Non-Hodgkin lymphomas should be included in the differential diagnosis of soft tissue masses in human immunodeficiency virus - seropositive patients.

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A large mass involving soft tissues in the chest wall, without compromising theskin or axillary lymphadenopathy
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f01: A large mass involving soft tissues in the chest wall, without compromising theskin or axillary lymphadenopathy

Mentions: The patients were clinically staged according to the Ann Arbor system. Primary NHL ofthe soft tissue was defined as those lymphomas presenting with involvement of the softtissue or the muscle as the predominant manifestation of the disease. Patients withcutaneous or bone tissue involvement were excluded. All diagnoses were performed byhistopathological examination of biopsy smears obtained from the soft tissue masses.Histopathological diagnosis was made according to the criteria of the World HealthOrganization (WHO).2Immunohistochemical stains were applied in all cases. During an 11-yearperiod analyzed in our hospital for infectious diseases, 92 HIV-infected patients werediagnosed with lymphoma. Sixty-six (72%) of them had NHL and 26 (28%) had Hodgkin'sdisease. Of 66 NHL, 41 (64%) were extranodal NHL and 4 (0.09%) were soft tissue primaryNHL. All were males with a median of age of 41 years. Clinical presentation showedpainless and large subcutaneous masses with rapidly increasing size. Two patients withhistory of intravenous drug use (IVDUs) had antibodies against hepatitis C virus (HCV)and the other 2 presented positive hepatitis B (HBV) serology. Lactate dehydrogenase(LDH) levels were elevated in the 4 patients and only one patient (25%) had evidence ofbone marrow infiltration. Sites of involvement included the chest wall in all of them(Figures 1 and 2) with other masses in the upper leg and the scalp in two.Histopathological and immunophenotype studies revealed 2 plasmablastic lymphomas (PBL),1 diffuse large B cell lymphoma (DLBCL) and 1 Burkitt lymphoma (BL). Two patients diedafter a short survival time following lymphoma diagnosis due to an aggressive and rapidclinical course of the neoplasm and disseminated tuberculosis, respectively, without thepossibility of receiving chemotherapy because of his poor clinical status. One patientdied 12 months later of unrelated cause and the other is alive. Demographic and clinicalfindings are summarized in tables 1 and 2.


Soft-tissue masses as presentation of non-Hodgkin's lymphoma in AIDS patients.

Corti M, Villafañe MF, Bistmans A, Campitelli A, Narbaitz M - An Bras Dermatol (2013 Jul-Aug)

A large mass involving soft tissues in the chest wall, without compromising theskin or axillary lymphadenopathy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3760945&req=5

f01: A large mass involving soft tissues in the chest wall, without compromising theskin or axillary lymphadenopathy
Mentions: The patients were clinically staged according to the Ann Arbor system. Primary NHL ofthe soft tissue was defined as those lymphomas presenting with involvement of the softtissue or the muscle as the predominant manifestation of the disease. Patients withcutaneous or bone tissue involvement were excluded. All diagnoses were performed byhistopathological examination of biopsy smears obtained from the soft tissue masses.Histopathological diagnosis was made according to the criteria of the World HealthOrganization (WHO).2Immunohistochemical stains were applied in all cases. During an 11-yearperiod analyzed in our hospital for infectious diseases, 92 HIV-infected patients werediagnosed with lymphoma. Sixty-six (72%) of them had NHL and 26 (28%) had Hodgkin'sdisease. Of 66 NHL, 41 (64%) were extranodal NHL and 4 (0.09%) were soft tissue primaryNHL. All were males with a median of age of 41 years. Clinical presentation showedpainless and large subcutaneous masses with rapidly increasing size. Two patients withhistory of intravenous drug use (IVDUs) had antibodies against hepatitis C virus (HCV)and the other 2 presented positive hepatitis B (HBV) serology. Lactate dehydrogenase(LDH) levels were elevated in the 4 patients and only one patient (25%) had evidence ofbone marrow infiltration. Sites of involvement included the chest wall in all of them(Figures 1 and 2) with other masses in the upper leg and the scalp in two.Histopathological and immunophenotype studies revealed 2 plasmablastic lymphomas (PBL),1 diffuse large B cell lymphoma (DLBCL) and 1 Burkitt lymphoma (BL). Two patients diedafter a short survival time following lymphoma diagnosis due to an aggressive and rapidclinical course of the neoplasm and disseminated tuberculosis, respectively, without thepossibility of receiving chemotherapy because of his poor clinical status. One patientdied 12 months later of unrelated cause and the other is alive. Demographic and clinicalfindings are summarized in tables 1 and 2.

Bottom Line: Generally, Non-Hodgkin lymphomas of the soft tissue present as large subcutaneous masses without evidence of nodal or skin involvement.We describe four cases of primary Non-Hodgkin lymphomas of the soft tissue in patients infected with the human immunodeficiency virus.Non-Hodgkin lymphomas should be included in the differential diagnosis of soft tissue masses in human immunodeficiency virus - seropositive patients.

View Article: PubMed Central - PubMed

Affiliation: HIV/AIDS Department, Infectious Diseases, F. J. Muñiz Hospital, Buenos Aires, Argentina.

ABSTRACT
Primary soft tissue Non-Hodgkin lymphomas are very rare and account only for 0.1 % of the cases. Generally, Non-Hodgkin lymphomas of the soft tissue present as large subcutaneous masses without evidence of nodal or skin involvement. We describe four cases of primary Non-Hodgkin lymphomas of the soft tissue in patients infected with the human immunodeficiency virus. The most common site of involvement was the chest wall in all the patients; histopathological and immunophenotypic examination of the biopsy smears revealed two cases of plasmablastic lymphomas, one Burkitt and one diffuse large B-cell lymphoma. Non-Hodgkin lymphomas should be included in the differential diagnosis of soft tissue masses in human immunodeficiency virus - seropositive patients.

Show MeSH
Related in: MedlinePlus