Simultaneous Presentation of Relapsed Diffuse Large B-cell Lymphoma and Extrapulmonary Tuberculosis in a Patient With HIV: A Case Report

TL;DR

This case report describes an HIV patient who simultaneously developed relapsed lymphoma and tuberculosis, highlighting the challenges in diagnosing and treating co-occurring conditions.

Contribution

The paper presents the first known case of simultaneous relapsed DLBCL and extrapulmonary tuberculosis in an HIV-infected individual.

Findings

The patient had spinal cord involvement from DLBCL and mesenteric lymph node tuberculosis.

Biopsy is essential for confirming co-existing diagnoses in HIV patients.

IGRA has low sensitivity for detecting tuberculosis in HIV patients.

Abstract

Human immunodeficiency virus (HIV) infection is a strong risk factor for diffuse large B-cell lymphoma (DLBL) and tuberculosis. Both DLBCL and tuberculosis can have remarkably similar clinical presentations, proving to be a diagnostic and therapeutic challenge. We report the only known case of an HIV-infected individual who presented simultaneously with relapsed DLBCL in the form of spinal cord involvement and tuberculosis of the mesenteric lymph nodes. This case highlights the possibility of multiple co-existing diagnoses in HIV, and the need for a low threshold to obtain confirmation via biopsy. The interferon-gamma release assay (IGRA) has low sensitivity in detecting tuberculosis in patients with HIV. Adherence to antiretroviral therapy (ART) is crucial in achieving and maintaining remission in DLBCL.

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