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Pathology Research International
Volume 2011 (2011), Article ID 563216, 5 pages
http://dx.doi.org/10.4061/2011/563216
Case Report

Immunophenotypical Switch versus Tumor Heterogeneity in a Patient with HIV-Associated Diffuse Large B-Cell Lymphoma

1Division of Hematology and Oncology, The Miriam Hospital, The Warren Alpert Medical School of Brown University, 164 Summit Avenue, Providence, RI 02906, USA
2Department of Pathology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA

Received 30 July 2010; Revised 16 September 2010; Accepted 21 September 2010

Academic Editor: Liron Pantanowitz

Copyright © 2011 Jorge J. Castillo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with HIV/AIDS have a higher risk of developing aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma (DLBCL). Lymphomas are rather heterogeneous in nature and in a few cases can switch their genetic or immunohistochemical phenotype, transform into other lymphomas or carry more than one malignant clone. In this report, we present the case of a 47-year-old man with HIV infection who was diagnosed with an apparent low-risk, early-stage DLBCL, but became refractory to therapy while undergoing treatment with rituximab-containing chemotherapy. We postulate that the development of his refractory disease occurred in the context of an immunohistochemical switch or the surge of a clone refractory to therapy. This phenomenon was not associated with a superinfection with EBV or HHV-8.