Linfoma no Hodgkin T/NK nasal en un paciente con VIH y coinfección viral: reporte de caso

Introduction: Nasal-type T/NK-cell lymphoma is a rare and aggressive neoplasm associated with Epstein–Barr virus (EBV). Its coexistence with HIV and other viral coinfections is exceptional, presenting major diagnostic and therapeutic challenges. Case presentation: A 43-year-old woman with well-controlled HIV presented with progressive cervical swelling, evening fever, fatigue, and nasal obstruction. Imaging revealed bilateral cervical masses and nasopharyngeal thickening. Nasopharyngeal biopsy confirmed T/NK-cell non-Hodgkin lymphoma (CD45+, CD30+, CD56+) with positive serology for EBV, CMV, and HSV. She received combined chemoradiotherapy (AspaMetDex regimen) but developed severe thrombocytopenia and fatal intracerebral hemorrhage. Discussion: The coexistence of HIV-induced immunosuppression and multiple viral coinfections may enhance EBV-driven oncogenesis and worsen disease progression. Therapeutic response is limited, and hematologic toxicity is frequent in immunocompromised hosts. Conclusion: This case highlights the diagnostic and therapeutic complexity of nasal T/NK-cell lymphoma in immunocompromised patients and underscores the importance of multidisciplinary management, early suspicion, and close monitoring during therapy to minimize fatal adverse events.