A Rare Case of Primary Gastric HIV-Associated Peripheral T-Cell Lymphoma: Relapsed Disease Treated With Pemetrexed

We present a case of a patient with HIV/AIDS who presented with abdominal pain and melena and was found to have gastric peripheral T-cell lymphoma (PTCL). He was treated with 6 cycles of EPOCH with a complete response. Within 3 months, he had central nervous system (CNS) and soft-tissue relapse. He was subsequently treated with 3 cycles of intravenous pemetrexed and experienced a second complete response. To our knowledge, there are fewer than 100 reports of HIV-associated PTCL worldwide as of 2010, and among these cases involvement of the stomach as the primary site of extranodal disease is exceptionally rare. The disease carries a poor prognosis and current standard therapies highlight the importance of HIV/AIDS disease control and the need for more studies on therapies and the role of transplantation in refractory or relapsed HIV-associated PTCL.