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Primary chest wall Burkitt lymphoma in a case of HIV infection with immune reconstitution
  1. Arihant Jain1,
  2. Vijayalakshmi Aravindan Arun2,
  3. Amanjit Bal3 and
  4. Pankaj Malhotra1
  1. 1Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Internal Medicine, Armed Forces Medical College, Pune, India
  3. 3Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Arihant Jain; drarihantjain86{at}gmail.com

Abstract

Burkitt lymphoma (BL) develops at an increased frequency in patients with HIV irrespective of the CD4 count. Lymph nodes and gastrointestinal tract are common sites of involvement by BL; however, primary chest wall BL is rare. A 52-year-old man on highly active antiretroviral therapy (HAART) for HIV with a CD4 count of 0.204 x 109 cells/L presented with a 3-month history of enlarging chest wall mass. PET-CT scan imaging showed a bulky mass involving the musculoskeletal planes of left chest wall with the involvement of underlying pleura. Biopsy with immunohistochemistry confirmed BL. Patient received EPOCH-R (infusional etoposide, vincristine, and doxorubicin with prednisone, cyclophosphamide and rituximab) regime for six cycles along with HAART, attained complete remission (CR) and remains free of BL at 5 years. BL should be considered in the differential diagnosis of soft tissue masses in HIV-infected patients irrespective of their CD4 count.

  • infections
  • malignant disease and immunosuppression
  • haematology (incl blood transfusion)

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Footnotes

  • Contributors AJ and VAA drafted the manuscript and were involved inmanagement of the case. AB reviewed the biopsy. PM contributed to the patientmanagement.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.