Non-Hodgkins lymphoma (NHL) with cutaneous involvement is an uncommon presentation involving 5-10% of total extra nodal NHL. Incidence of NHL is 60-200 times higher in HIV positive patients. Diffuse large B cell lymphoma (DLBCL) accounts for 25-30% of HIV associated lymphomas. A 38 year old HIV-1 seropositive male patient presented with multiple swellings over abdominal wall of 3 months duration and pain in upper abdomen of 1 month duration. On examination multiple nodular swellings over abdominal and chest wall measuring 1x1 to 3x3 cms were seen, which were non-tender, immobile and firm in consistency. Per abdominal examination showed tenderness in epigastrium.
Laboratory investigations revealed anemia, neutrophilia and raised ESR. CD4 count was 33 cells/µl. USG abdomen revealed thickened stomach wall and abdominal wall lesions. Chest x-ray and bone marrow examination were unremarkable.
FNAC and histopathological examination of the nodular swelling showed features of cutaneous NHL and by immunohistochemistry a diagnosis of diffuse large B-cell lymphoma, Activated B-cell type (High grade) was made. However before any intervention could be started, the patient expired within four days. DLBCL though fatal, are potentially curable mandating early diagnosis followed by specific therapy.
Cutaneous, lymphoma, NHL, DLBCL, AIDS