Obstructive biliary symptomatology as the first sign of HIV-infection

G. De Toma, M. Codacci-Pisanelli, V. Nicolanti, M. Plocco, S. Caterino, C. F. Perno

Research output: Contribution to journalArticlepeer-review

Abstract

A 41-years-old white homosexual man presented with epigastric pain and jaundice. Physical examination showed enlargement of bilateral axillar and left inguinal lymph node, while ERCP and a CT scan suggested interruption of bile flow in the intrapancreatic tract of the common bile duct. An endoprosthesis was positioned in the common bile duct during the ERCP. Blood tests (both ELISA and Western blot techniques) showed positivity for anti-HIV antibodies and a CD4 count of 780/mmc (normal: 900-1,200/mmc). A few days later, a dramatic increase of the size of a lymph node in this right axilla occurred, rapidly reaching 5 cm of diameter. A biopsy was performed at this level, and histological examination revealed a high grade B-cell Burkitt type lymphoma. Bone marrow biopsy was negative, as well as lumbar puncture. Aggressive chemotherapy with adriamycin, cyclophosphamide, bleomycine, eldesine and prednisone, together with intratechal administration of methotrexate, was attempted. However, after a marginal and transient regression, the NHL rapidly progressed and the patient eventually died seven months after the diagnosis of NHL. A post mortem examination confirmed the diagnosis of Burkitt lymphoma of the peripancreatic and axillar lymph nodes, with diffusion to the leptomeninges, sub-aracnoideal spaces and encephalus. No signs of lymphoma were detected in other nodal or extra nodal areas.

Original languageEnglish
Pages (from-to)459-462
Number of pages4
JournalJournal of Experimental and Clinical Cancer Research
Volume18
Issue number4
Publication statusPublished - Dec 1999

Keywords

  • AIDS
  • Biliary
  • Burkitt
  • HIV
  • Infection
  • Lymphoma
  • Non-Hodgkin
  • Ostructive

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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