2025 Volume 67 Issue 2 Pages 155-161
A 41-year-old man, who had been receiving biologic therapy for collagen disease, was admitted to the emergency department with melena. An ulcer was found in the anorectal region. Based on an endoscopic biopsy, cytomegalovirus infection and other iatrogenic immunodeficiency-related conditions, including lymphoproliferative disorders, were suspected. As a result, the biologic treatment was stopped. However, the ulcer did not heal.
Five months after the initial diagnosis, a repeat biopsy revealed a small number of cells that were suggestive of lymphoma. Further tests confirmed that the patient was infected with HIV. The biopsy also detected Epstein-Barr virus (EBV)-encoded small RNA-positive cells. Based on these findings, the patient was diagnosed with HIV-associated lymphoma, specifically an EBV-positive diffuse large B-cell lymphoma.
This case highlights the importance of considering sexually transmitted infections, including HIV, in the differential diagnosis of anorectal lesions.
