Epstein-Barr virus (EBV)-positive
diffuse large B-cell lymphoma (DLBCL) complicated with angioimmunoblastic
T-cell lymphoma (AITL) is extremely rare and typically shows an aggressive
clinical course and unsatisfactory prognosis. Here, we describe the case of a 77-year-old man who was referred to the hospital because of repeated
fever, night sweats, and
weight loss. He was finally diagnosed with a discordant
lymphoma consisting of AITL and DLBCL, with significantly different maximum standardized uptake values on positron emission tomography/computed tomography. Based on his complex illness and poor performance status, the patient received six cycles of
lenalidomide combined with R-miniCHOP regimen and achieved complete remission with tolerable and controlled toxicity. He subsequently received
lenalidomide maintenance
therapy and achieved sustained remission. We consider the possible causes of this discordance involved AITL and EBV-positive DLBCL, and the possible mechanism of
lenalidomide action in both T-cell and B-cell non-Hodgkin
lymphomas.
Lenalidomide-combination
therapy may be a preferable choice in patients with an EBV-associated discordant
lymphoma.