López-Iñiguez A, Mariscal-Álvarez FJ

Language: Spanish
References: 10
Page: 111-115
PDF size: 689.26 Kb.

ABSTRACT

A 20 year old female seeks medical consult for presenting a mass on the right lateral side of her neck beginning 5 months ago. The clinical manifestations include: odynophagia that began when an amygdalin ulcer formed on the same side of the neck mass, dysphagia to solids, halitosis, 38° - 39°C fever, and a 5 kg weight loss. All of the symptoms have been exacerbated in the last month. An ELISA test was performed 15 days ago, which was positive for HIV. Contrast and non – contrast neck CT scans were taken, in which a lesion that occupies naso, oro and hypopharinx is shown. Lesion is heterogenic with hypodensities suggestive of necrotic or abcedated areas that obstruct over 50% of the airway, with multiple deep regional adenopathies and a submandibular adenopathy on the same side. Histopathology biopsy of the pharynx reports diffuse large B cell Non Hodgkin Lymphoma. HIV infection causes an immunologic dysregulation, which originates the appearance of neoplasia and opportunistic infections. One of the most prevalent HIV associated neoplasia is Non Hodgkin Lymphoma (NHL), being the second most frequent neoplasia associated with HIV. Histoplasma capsulatum is the most frequent systemic mycoses in this population. The association between these two pathologies has been rarely reported, mainly case reports in which Histoplasmosis emulates NHL. We present a case in a young patient diagnosed with HIV who debuts with diffuse large B cell NHL and Histoplasmosis.

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