HIV, Intussusception, and a Hidden Malignancy Masquerading Abdominal Tuberculosis: Diffuse Large B-Cell Lymphoma Unveiled
Year: 2025
Type: article
Study design: Case Report
Abstract: Diffuse large B-cell lymphoma (DLBCL) is a common aggressive non-Hodgkin lymphoma, frequently seen in immunocompromised individuals. This report details the case of a 40-year-old HIV-positive female admitted for abdominal pain, vomiting, and imaging suggestive of disseminated tuberculosis, who was ultimately diagnosed with DLBCL of the ileum complicated by intussusception. Initial investigations revealed anemia and thrombocytosis. Contrast-enhanced CT showed multiple necrotic granulomatous lesions and jejunoileal intussusception, mimicking tuberculosis. Surgical exploration and resection of the intussuscepted ileal segment revealed a polypoidal tumor. Histopathological examination indicated a diffuse proliferation of lymphoma cells with plasmacytoid morphology. Immunohistochemistry confirmed DLBCL (germinal center B-cell subtype), with tumor cells positive for Oct-2, CD20, PAX5, BCL-6, and CD10 and negative for CD38, CD138, and MUM1. This case highlights the diagnostic challenges in differentiating intestinal DLBCL from infectious and inflammatory conditions such as tuberculosis in HIV-positive patients. It underscores the commentative role of biopsy and immunohistochemistry in accurate diagnosis and timely initiation of appropriate therapy, ultimately improving patient outcomes.
Source: Cureus
DOI: 10.7759/cureus.83072
Authors: Mitali Singh, Vaibhav Mane
Institution: Bharati Vidyapeeth (Deemed to be University)
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409851760