Journal of Clinical and Experimental Hematopathology
Online ISSN : 1880-9952
Print ISSN : 1346-4280
ISSN-L : 1346-4280
Case Study
Development of Primary Central Nervous System Lymphoma Associated with Human Immunodeficiency Virus and JC Virus Infection
Toru KawakamiKaoko SakaiYuto MimuraYasushi SenooYukio HirabayashiHideyuki NakazawaHiroshi KoshiharaKenya OguchiYo-ichi TakeiShinji OharaNobuaki WatanabeKou NakazawaKiyomitsu OyanagiKiyoshi Kitano
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2014 Volume 54 Issue 3 Pages 211-217

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Abstract

We report here a case of a 37-year-old man with human immunodeficiency virus (HIV) infection followed by JC virus (JCV) infection and primary central nervous system lymphoma (PCNSL). The patient had been infected with HIV type 1 due to blood products for hemophilia A during infancy. He had progression of nervous symptoms and was diagnosed with progressive multifocal leukoencephalopathy (PML) clinically at the age of 36, when his CD4-positive lymphocyte counts ranged between 350 and 450/μl. Oral mefloquine, intravenous methylprednisolone pulse therapy, and intravenous immunoglobulin were not effective for the PML, and the patient entered a vegetative state. Brain biopsy revealed JCV infection without pathological findings of PML. Eight months after the clinical diagnosis of PML, he developed respiratory failure and brain magnetic resonance imaging revealed a mass lesion in the brain stem. The patient died 19 months after the diagnosis of PML. Autopsy findings were compatible with PCNSL. EBV-encoded small RNA-1-positive cells were not detected. We present a case of JCV-positive PCNSL with HIV infection complicated with clinical PML.

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© 2014 by The Japanese Society for Lymphoreticular Tissue Research
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