Analysis of atypical clinical manifestations in eight patients with AIDS complicated by lymphoma

Objective

Acquired Immunodeficiency Syndrome (AIDS)-related lymphoma has diverse clinical manifestations, and its diagnosis is often challenging. Misdiagnosis can delay treatment and affect patient prognosis. We assessed the clinical data of eight patients with atypical clinical manifestations of AIDS-related lymphoma, to enhance physicians' understanding of these patients, and reduce the potential for misdiagnosis.

Methods

A retrospective analysis was conducted on eight patients with atypical manifestations of AIDS-related lymphoma admitted to the Department of Infectious Diseases of Yunnan Provincial Hospital between May 2017 and May 2023. They were initially misdiagnosed with opportunistic infections, and were later diagnosed with lymphoma.

Results

The patients comprised five males and three females. Cluster of Differentiation 4 (CD₄) counts were lower than 200/μl for all patients, and inflammatory marker levels were elevated to varying degrees. Four patients had recurrent fever, one had bleeding, one had pulmonary infection, one had long-term diarrhoea, and one had visual impairment as the primary symptoms. Six patients were diagnosed through bone marrow cytology and biopsy, one through colonoscopy and pathological biopsy, and one through computed tomography-guided percutaneous lung biopsy. All patients had extranodal involvement, including one case in the intestine, one in the lung, and six in the bone marrow. All patients were at lymphoma stage IV, with four in Group A and four in group B.

Conclusion

In patients with AIDS, particularly those with low CD4 counts and unexplained fever, atypical lymphoma should be considered, and tissue biopsy should be performed to further confirm the diagnosis.