Literature review of one case of follicular lymphoma complicated with iliac bone Cryptococcus neoformans infection

OBJECTIVE To conduct a literature review of one case of follicular lymphoma complicated with iliac bone Cryptococcus neoformans infection so as to raise the understanding of such pathogen in the field of HIV-negative Hodgkin′s/non-Hodgkin′s lymphoma.

METHODS The clinical data were collected from one case of follicular lymphoma patient complicated with C. neoformans infection who was treated in Xinrui Hospital of Xinwu District, Wuxi City on Feb. 24, 2023 and retrospectively analyzed. All of relevant literatures regarding to the subject were retrieved in Pubmed, CNKI, Wanfang and VIP databases, and the clinical data of the patients with HIV-negative Hodgkin′s/non-Hodgkin′s lymphoma with C. neoformans infection were screened out and summarized.

RESULTS The case was a 28-year-old male and had the underlying disease of follicular lymphoma. The C. neoformans was detected by iliac bone histopathology and metagenome next generation sequencing (mNGS). The condition of the patient improved after the treatment with amphotericin B cholesterol sulphate compound and fluconazole. A total of 28 patients, with this case included, were involved in the literature review, 23 of whom were male, and 5 were female, and the age ranged between 16 and 79 years old. With respect to major infection sites, there were 15 (53.57%) cases of cerebral infection, 9 (32.14%) cases of blood infections, 7 (25.00%) cases of pulmonary infection, 4 (14.285%) cases of skin infections, 2 (7.14%) cases of muscle tissue infections, 2 (7.14%) cases of pleural effusion infections, 2 (7.14%) cases of bone infections and 1 (3.57%) case of bone marrow infection. Totally 11 patients had disseminated Cryptococcus infection, accounting for 39.28%.

CONCLUSIONS The C. neoformans infection is seldom detected in the patients with HIV-negative Hodgkin′s/non-Hodgkin′s lymphoma. The brain is the major infection site with the high probability of disseminated infection. It is necessary for the hospital to deepen the understanding of the pathogen in the field of HIV-negative Hodgkin′s/non-Hodgkin′s lymphoma.