Primary Gastric Non-Hodgkin Lymphoma as Second AIDS-Defining Malignancy in a Patient under HAART - Abstract
Primary gastric non-Hodgkin lymphoma is a severe complication during the clinical course of human immunodeficiency virus infection. Clinical presentation includes symptoms associated with the upper digestive tract and “B” symptoms (fever, night sweats and weight loss). Endoscopic findings can reveal polypoid, ulcero-infiltrative or ulcer lesions. Multiple biopsy smears are necessary to determine histopathological subtypes. Diffuse large B cell lymphoma (DLBCL) is the most common histopathological subtype in HIV/AIDS patients followed by Burkitt’s lymphoma and plasmablastic lymphoma. Chemotherapy plus highly active antiretroviral therapy is the best treatment to achieve a complete remission with prolonged survival in this kind of patients. Here we present an HIV seropositive patient who developed a primary gastric DLBCL as second AIDS-defining neoplasm during HAART therapy and after three years of successfully controlling HIV-viral load. Patient presented with a past history of anal squamous cell carcinoma several years before and gastro esophageal reflux disease treated for a long time with omeprazole. He presented with epigastric pain, nausea and dyspepsia. Upper gastrointestinal endoscopy showed erosive gastritis and a large gastric ulcer at the minor gastric curvature. Microscopy examination and immunohistochemistry of the biopsy smears of the large ulcer biopsy confirm the diagnosis of primary gastric DLBCL. He was treated with HAART plus chemotherapy with a complete remission for a time of three years.