Primary B-Cell jejunal maltoma in a young adult male: A case report and review of literature

Sir, I read with interest the case report by Ezejiofor et al.[1] on the primary B-cell jejunal maltoma, a rare variety of lymphoma, in a Nigerian patient. The authors described nicely the clinical presentation, results of imaging studies, laparotomy and histopathological findings, and treatment plan in the studied patient. I presume that the rare occurrence of the tumor and its aggressive nature should alert the authors to consider altered immune status in the studied patient. Among conditions associated with altered immune states, human immunodeficiency virus (HIV) infection is of utmost importance. My presumption is based on the following points. It is obvious that individuals infected with HIV are more susceptible to various types of tumors compared to healthy individuals. The increased susceptibility has been suggested to be related to different factors, including immunosuppression, coinfection with oncogenic viruses, and life prolongation secondary to the use of antiretroviral therapy.[2] Among tumors, intestinal lymphoma has been reported among HIV-positive patients.[3,4] To my knowledge, Nigeria is one among the Sub-Saharan countries importantly facing the serious health consequences of HIV infection. The recently published data pointed out to the substantial HIV seroprevalence (3.2%) in Nigeria.[5] Hence, determining HIV status in the studied patient by the diagnostic battery of blood CD4 count and viral overload estimations was envisaged. If that cluster of tests were to reveal HIV infection, the case in question could be truly regarded as a novel case report. This is because HIV-associated B-cell intestinal maltoma has never been reported in the literature to date. Financial support and sponsorship