Primary bile duct CD20-negative B cell lymphoma presenting as cholestatic jaundice in a patient with HIV
2
Issued Date
2026-05-22
Resource Type
eISSN
1757790X
Scopus ID
2-s2.0-105039957184
Pubmed ID
42173532
Journal Title
BMJ Case Reports
Volume
19
Issue
5
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Case Reports Vol.19 No.5 (2026)
Suggested Citation
Kokkeadtikul T., Sorananuphap P., Karnchanatanalert P., Karoopongse E. Primary bile duct CD20-negative B cell lymphoma presenting as cholestatic jaundice in a patient with HIV. BMJ Case Reports Vol.19 No.5 (2026). doi:10.1136/bcr-2026-272025 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117049
Title
Primary bile duct CD20-negative B cell lymphoma presenting as cholestatic jaundice in a patient with HIV
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Corresponding Author(s)
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Abstract
Primary bile duct lymphoma is an exceptionally rare cause of biliary obstruction and may mimic cholangiocarcinoma or AIDS cholangiopathy on imaging particularly in immunocompromised patients. We report a man in his 30s with a newly diagnosed HIV infection (CD4 count 153 cells/µL) who presented with progressive jaundice, weight loss, fever and abdominal pain. Initial laboratory investigations revealed a cholestatic pattern of liver injury. Imaging demonstrated diffuse biliary strictures, infiltrative lesions and a hypovascular mass, initially suggestive of cholangiocarcinoma or sclerosing cholangitis. Endoscopic ultrasound-guided fine-needle aspiration and brush cytology revealed a CD20-negative, PAX5+/CD79a+B cell lymphoma. The patient was treated with antiretroviral therapy and CHOP-based chemotherapy with intrathecal therapy, resulting in rapid clinical improvement. This case highlights the diagnostic challenge of biliary obstruction in advanced HIV and underscores the importance of tissue diagnosis in distinguishing lymphoma from infection or other malignancies.