1. CD4-Positive T-Cell Primary Central Nervous System Lymphoma in an HIV Positive Patient.
- Author
-
Nael, Ali, Walavalkar, Vighnesh, Wu, William, Nael, Kambiz, Kim, Ronald, Rezk, Sherif, Xiaohui Zhao, and Zhao, Xiaohui
- Subjects
- *
CD4 antigen , *HIV , *HIV infections , *CEREBROSPINAL fluid , *LYMPHOMAS , *B cell lymphoma - Abstract
Objectives: Primary central nervous system lymphomas (PCNSLs) in patients with human immunodeficiency virus (HIV) are predominantly B-cell lymphomas associated with Epstein-Barr virus (EBV) and rarely CD8-positive T-cell PCNSLs.Methods: Patient history, laboratory results, cerebrospinal fluid (CSF), imaging, and brain biopsy specimens were reviewed and tested for T-cell receptor clonality.Results: A 64-year-old HIV-positive woman sought treatment for lethargy and left-sided weakness. Brain imaging showed regional increased T2 signal with restricted diffusion in cerebral hemispheres. CSF flow cytometry revealed CD4-positive T lymphocytes with loss of CD3, CD5, and CD7. EBV-positive T-cell lymphoma was immunohistochemically confirmed on brain biopsy specimens. Molecular analysis detected clonal T-cell receptor gene rearrangement. The patient received intrathecal methotrexate and whole-brain radiation. She did not respond to treatment and was eventually placed in hospice care.Conclusions: To our knowledge, this is the first report of CD4-positive T-cell PCNSL in an HIV-positive patient and will help to raise clinical awareness of this previously unknown entity. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF