Disseminated non-Hodgkin's lymphoma and chronic hepatitis C: a case report

Hepatitis C virus (HCV) infection is occasionally associated to B-cell type non-Hodgkin's lymphoma. Evidence showing a possible etiological link between HCV and lymphoma has been reported from areas of high HCV prevalence. We describe the case of a 68-year-old woman with B-cell non-Hodgkin's lymphoma mainly involving the skin. Typical manifestations of disease were cutaneous nodules, red-violet in color, scattered on the entire body and adherent to the subcutaneous tissue. A 3-cm nodule excised from the leg was found at histology to consist of centroblastic-like B cells, which stained positively for CD45, CD20 and CD79a. Although the patient was treated with different chemotherapy schedules, she died 1 year later with a diagnosis of disseminated lymphoma. Our report suggests that HCV, a trigger for clonal B-cell proliferation, predisposing to immunological disorders, such as mixed cryoglobulinemia and B-cell malignancies, may also account for the "rare" extranodal high-grade non-Hodgkin's lymphoma. Further observations suggest that treating HCV infection with antiviral therapy could help to prevent the development of B-cell non-Hodgkin's lymphoma.