Pulmonary mucosa-associated lymphoid tissue lymphoma presenting with a diffuse micronodular pattern in an HIV-infected patient.

Mucosa-associated lymphoid tissue (MALT) lymphoma is an extranodal B-cell lymphoma seen in various types of epithelial tissues, such as those of the stomach, salivary glands, lungs, and small intestine.(1) Although pulmonary MALT lymphoma—also known as bronchial-associated lymphoid tissue (BALT) lymphoma—is a rare disease, it is the most common form of primary low-grade pulmonary lymphoma.(2) Some reports have associated pulmonary MALT lymphoma with Sjögren’s syndrome and other immunological diseases.(3) Case reports of pulmonary MALT lymphoma in HIV-infected patients are rare. (4) Here, we report the case of an HIV-positive patient with pulmonary MALT lymphoma presenting with a diffuse micronodular pattern on chest X-rays and CT scans. A 38-year-old single Black male sought treatment at a tertiary-care hospital in the city of Rio de Janeiro, Brazil. He was a native of the city and was employed as a cook. He had been HIV-positive since 2001 and was being followed at an outpatient clinic for infectious and parasitic diseases. He was not on antiretroviral therapy. The most recent CD4 count, performed in November of 2008, was 565 cells/mm3. The onset of pulmonary manifestations, including fever, cough, and intermittent episodes of mild hemoptysis, occurred in December of 2008. The patient sought treatment at a teaching received antibiotic therapy with amoxicillin (500 mg every 8 h for 7 days). Although the fever subsided and the hemoptysis lessened, the dry cough persisted. He denied other symptoms, such as weight loss, night sweats, and worsening of the overall health status. The patient was referred to the pulmonology department of the hospital for further investigation. Physical examination revealed no significant changes. A chest X-ray Pulmonary mucosa-associated lymphoid tissue lymphoma presenting with a diffuse micronodular pattern in an HIV-infected patient