Spontaneous regression of cutaneous T cell lymphoma in an HIV-positive patient

Case Details

Disease Location

Skin

Personal Characteristics

35-year-old gentleman. History of HIV. Tenofovir disoproxil/ emtricitabine and efavirenz were started in the previous 3 months before consultation

Clinical Characteristics

2-month history of multiple painful, ulcerated plaques on the forehead, penile shaft, and dorsum of left foot. Physical examination revealed ulcerated plaques with slough and crust on forehead and dorsum of left foot and a solitary ulcer over penile shaft with slough. Skin biopsies were done from the lesion on the forehead. Histopathological examination revealed epidermal ulceration and infiltration of the dermis with atypical lymphoid cells showing pleomorphic and hyperchromatic nuclei. On immunohistochemistry, the atypical lymphoid cells were positive for CD3 and CD7 with downregulation of CD5. A diagnosis of peripheral t cell lymphoma was made. CT of brain, neck, thorax, abdomen and pelvis revealed enlarged bilateral submandibular gland, external iliac and inguinal lymph nodes

Remission Characteristics

Pon follow-up visit 3 months later, there was remarkable improvement of patient’s lesions with complete resolution

Treatment & Mechanisms

Proposed Remission Mechanisms

The immune reconstitution effects of art with recovery of CD4 count and reduction in HIV viral load were thought to be responsible for the spontaneous regression of lymphoma among these patients

Clinical Treatment

Tenofovir disoproxil/ emtricitabine and efavirenz

Non-Clinical Treatment

None reported