Challenging differential diagnosis, Unusual setting of medical care, Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology
Faizan Malik, Naveed Ali, Syed Imran Mustafa Jafri, Christian Fidler
(Department of Internal Medicine, Abington Hospital Jefferson Health, Abington, PA, USA)
Am J Case Rep 2017; 18:553-557
Immunosuppressive diseases and therapies have long been connected to risk of malignancies, especially lymphoma. With some diseases and drugs, the association is well established but the data is mostly anecdotal because of the rarity of the situation.
CASE REPORT: We present 2 rare cases. The first patient had psoriasis, was on etanercept, and developed Hodgkin’s lymphoma. This case is rare because psoriasis and etanercept do not usually cause lymphoma, and if they do, it is predominantly Epstein-Barr virus-positive non-Hodgkin’s lymphoma. The second patient had acquired immune deficiency syndrome (AIDS) and developed Hodgkin’s lymphoma while on highly active antiretroviral therapy (HAART). This case is rare because AIDS mostly causes Kaposi’s sarcoma or non-Hodgkin’s lymphoma due to immunosuppression, but whether it is AIDS or HAART therapy that leads to development of Hodgkin’s lymphoma in these patients is not clear.
CONCLUSIONS: Immunosuppression seems to be the primary culprit leading to lymphomas in these cases. The exact mechanism is still not completely understood.
Keywords: Hodgkin Disease, Lymphoma, AIDS-Related, Lymphoma, B-Cell, Psoriasis