好色先生

好色先生

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Abstract Details

Co-occurrence of Follicular Lymphoma and CNS Intravascular Lymphoma in a patient with HIV/AIDS: A Case report
Neuro-oncology
P3 - Poster Session 3 (5:30 PM-6:30 PM)
7-012
NA
Human immunodeficiency virus (HIV) infection causes a range of neurological disorders including HIV-associated neurocognitive disorder, myopathy, polyneuropathy, progressive multifocal leukoencephalopathy and opportunistic infections. Patients also have a higher incidence of B-cell lymphomas, which are considered defining of acquired immune deficiency syndrome (AIDS). Intravascular lymphoma (IVL) is a rare and aggressive large B-cell lymphoma characterized by deposition of neoplastic lymphocytes within small to medium blood vessels and is generally associated with an extremely poor prognosis.
Case Report: A 55-year-old man with history of intravenous drug use, reported 7 weeks of lower extremity weakness, profound progressive altered mentation, and weight loss. Work up revealed diffuse lymphadenopathy and new HIV seropositivity (CD4 100/uL). Lymph node biopsy revealed systemic B-cell follicular lymphoma, grade 3A (negative for t(14;18), expressing CD19, CD20, HLA-DR, CD45 and sIg lambda). MRI brain showed patchy bilateral T2-weighted hyperintensities in a watershed distribution with scattered multifocal diffusion restriction and mild enhancement in a stroke-like pattern suggestive of either infectious, autoimmune, or malignant process. Lumbar puncture showed 2 cells/mm3, protein 176 mg/dL without malignancy. Brain biopsy confirmed histopathologic diagnosis of intravascular lymphoma (expressing CD45, CD20, Bcl-6 and MUM-1; negative for CD34, CD10, Bcl-2 and EBV by in-situ hybridization). Highly active antiretroviral therapy (HAART) was initiated promptly. Ibrutinib was requested through pharmaceutical assistance as patient was without health insurance and EPOCH initiated, however, symptoms progressed and patient's family elected for hospice.
NA
IVL has protean manifestations that frequently involve the CNS and result in stroke-like lesions. Co-occurrence of low-grade follicular and higher-grade IVL is uncommon and has not been reported in HIV/AIDS but can occur. Treatment of AIDS associated lymphoma is challenging and requires prompt initiation of HAART for immune reconstitution. AIDS-associated lymphomas are thought to be Bruton’s tyrosine kinase driven malignancies and may respond to BTK inhibition with Ibrutinib.
Authors/Disclosures
Ana Luisa de Carvalho Cardozo Hernández
PRESENTER 		Ms. de Carvalho Cardozo Hernández has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Justin W. Beuthin, DO (Spectrum Health) No disclosure on file
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine) Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SpringWorks . Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.