Extracavitary primary effusion lymphoma recurring with syphilis in an HIV-infected patient

A 59-year-old Caucasian man infected with HIV, in remission from human herpes virus-8-positive extracavitary primary effusion lymphoma (EC-PEL), presented to a sexual health clinic with fever and rectal pain 10 weeks after a single episode of receptive anal sexual intercourse with another man. He wa...

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Bibliographic Details
Published in:BMJ case reports 2020-11, Vol.13 (11), p.e235204
Main Authors: Sohail Ahmed, Darakhshan, Poliquin, Marc, Julien, Louis-André, Routy, Jean-Pierre
Format: Article
Language:English
Subjects:
Antigens
Biopsy
Blood tests
Case reports
Chlamydia
colon cancer
Colorectal cancer
Constipation
Cytomegalovirus
Endoscopy
Fever
Gonorrhea
Herpes viruses
HIV
HIV / AIDS
HIV Infections - complications
HIV Infections - diagnosis
Human immunodeficiency virus
Humans
infection (gastroenterology)
Infections
Kaposis sarcoma
Lymph Nodes - pathology
Lymphatic system
Lymphoma
Lymphoma, Primary Effusion - complications
Lymphoma, Primary Effusion - diagnosis
Male
Middle Aged
Neoplasm Recurrence, Local - diagnosis
Pain
Penis
Rectum - pathology
Sarcoma
Serology
Sexually transmitted diseases
STD
Syphilis
Syphilis - complications
Syphilis - diagnosis
Topography
Unusual Association of Diseases/Symptoms
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Summary:A 59-year-old Caucasian man infected with HIV, in remission from human herpes virus-8-positive extracavitary primary effusion lymphoma (EC-PEL), presented to a sexual health clinic with fever and rectal pain 10 weeks after a single episode of receptive anal sexual intercourse with another man. He was initially treated for a presumptive diagnosis of lymphogranuloma venereum proctitis, then for syphilis on positive serology. Rectosigmoidoscopy revealed a single ulcerated rectal mass; endoscopic biopsies confirmed the recurrence of EC-PEL. The patient received chemotherapy and went into remission. This is the first reported case of EC-PEL occurring synchronously with early syphilis, and specifically at the site of inoculation, which can be a major diagnostic challenge since both conditions may present with lymphadenopathy, mucosal involvement and constitutional symptoms. We reviewed the literature for similar cases and hypothesised that syphilis may have triggered the recurrence of this rare lymphoma.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235204