BMJ Case Reports 2012; doi:10.1136/bcr.11.2011.5217
  • Unusual presentation of more common disease/injury

Right upper quadrant pain and mass in a 41-year-old previously healthy man: a presenting feature of HIV-associated extranodal diffuse large B cell lymphoma with cardiac involvement

  1. Shilpi Gupta1
  1. 1Department of Haematology/Oncology, Staten Island University Hospital, Staten Island, New York, USA
  2. 2Department of Internal Medicine, Staten Island University Hospital, Staten Island, New York, USA
  3. 3Department of Nuclear Medicine and Positron Emission Tomography, Staten Island University Hospital, Staten Island, New York, USA
  1. Correspondence to Dr Srujitha Murukutla, srujitha.murukutla{at}


With an increasing pandemic of HIV/AIDS, the incidence of HIV-associated lymphoma is expected to rise. Here, the authors report a case of a 41-year-old man who presented with right upper quadrant pain and mass, and was subsequently diagnosed with HIV-associated diffuse large B cell lymphoma (DLBCL) with cardiac involvement. This case illustrates some of the uncommon and interesting aspects of DLBCL: primary extramedullary extranodal stage IV disease as the presenting feature; cardiac involvement at presentation; DLBCL as the only clue to the diagnosis of HIV; and management of HIV-associated DLBCL. This case is also a reminder of the importance of the routine HIV screening for all patients between the ages of 13–64 years, as advocated by centres of disease control and prevention.


  • Competing interests None.

  • Patient consent Obtained.

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