Primary Bone Marrow HIV-Associated Hodgkin Lymphoma Complicated by Hemophagocytic Lymphohistiocytosis

The presentation of human immunodeficiency virus (HIV)-associated Hodgkin lymphoma can differ from that of the general population. More specifically, primary bone marrow Hodgkin lymphoma is an uncommon presentation that is more often reported in patients with HIV. Given the many overlapping symptoms of Hodgkin lymphoma and HIV as well as HIV-associated infections, diagnosis can be difficult and delayed. We describe a case of primary bone marrow HIV-associated Hodgkin lymphoma complicated by hemophagocytic lymphohistiocytosis (HLH) where the initial work-up was inconclusive. Our case demonstrates the importance of early consideration of HLH as well as the need for an early bone marrow biopsy in a cytopenic patient with a fever of unknown origin.

Automated summary

The presentation of HIV-associated Hodgkin lymphoma can be different from the general population, and primary bone marrow involvement is more common in HIV patients. Diagnosis can be challenging due to overlapping symptoms with HIV and other associated infections, emphasizing the importance of early consideration of specific complications like hemophagocytic lymphohistiocytosis (HLH) and early bone marrow biopsy for cytopenic patients with fever of unknown origin.