Monday, May 11, 2009

Day #305 - HIV Lymphoma


Today we discussed a case of a patient with known HIV disease (CD4 300-500, not on therapy) who presented with fever, diffuse adenopathy, and splenomegaly. The presumed cause is lymphoma.









The differential diagnosis would include:

Infections:
    • HIV with high level viremia
    • Mononucleosis syndromes (EBV, CMV, acute toxoplasmosis)
    • Syphilis
    • Disseminated TB
    • In the more immunosuppressed host:
      • Mycobacterium Avium Complex
      • Bartonella Henselae
      • Disseminated fungal infection (i.e. histoplasmosis)
  • Non-infectious
    • Lymphoma
    • Multicentric Castleman's Disease
    • Sarcoidosis

I have previously blogged about HIV here, here (with cryptococcal meningitis), and here (with PCP pneumonia).

I have blogged about lymphoma including staging here.

A review of the pathology of HIV associate lymphomas is here. An article reviewing the treatment of HIV associated lymphoma is here.

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