Diffuse intestinal Kaposi's sarcoma shares macroscopicand histopathologic features with gastrointestinal stromatumors. Correct diagnosis may pose a clinical challengeWe describe the case of a young HIV-1-infected ...Diffuse intestinal Kaposi's sarcoma shares macroscopicand histopathologic features with gastrointestinal stromatumors. Correct diagnosis may pose a clinical challengeWe describe the case of a young HIV-1-infected Africanlady without advanced immunodeficiency, who presentedwith a diffuse spindle cell tumor of the gut. Initiadiagnosis was of a gastrointestinal stromal tumor, basedon endoscopy and histopathology. Further evaluationrevealed evidence for human herpesvirus 8 (HHV8) andthe diagnosis had to be changed to diffuse intestinaKaposi's sarcoma. Antiretroviral triple therapy togethewith chemotherapy was commenced, and has led to therapid remission of intestinal lesions. With a backgroundof HIV infection, the presence of HHV8 as the causativeagent of Kaposi's sarcoma should be determined, asdistinct treatment is indicated.展开更多
Background: HIV associated KS is relatively rare in children and has been reported to be higher in East Africa compared to other regions. Literature on cases of histologically proven Kaposi sarcoma in children with HI...Background: HIV associated KS is relatively rare in children and has been reported to be higher in East Africa compared to other regions. Literature on cases of histologically proven Kaposi sarcoma in children with HIV infection in West Africa is scanty. Case presentation: This communication presents three cases of KS seen among children in a paediatric HIV unit. The first case was an eleven year old HIV positive boy who had oral candidiasis that resolved with treatment and subsequently developed a painless, erythematous swelling at the middle of the dorsum of the tongue with central loss of papillae. He also had multiple discoid hyperpigmented flat lesions on the legs and soles of the feet. In addition to switching to second line antiretroviral therapy, he had chemotherapy. The lesions regressed. The second case was a double orphan who had KS involvement of the right eye, nasal cavity and lymph nodes. The tumour rapidly progressed and the child died before ART and chemotherapy could be commenced. The last case was a five year old girl with mild KS of the skin but also had other manifestations of severe HIV disease which she succumbed to. Incisional biopsies of the lesions revealed an invasive epithelial lined vascular tumour destroying the upper layers of skeletal fibres within the connective tissue stroma in keeping with KS. Human Herpes Virus type 8 (HHV8) screen was also positive for all the cases. Conclusion: A high index of suspicion must be entertained and biopsy of suspicious muco-cutaneous lesions is necessary to exclude a diagnosis of KS which is an indicator of severity and progression of HIV.展开更多
Kaposi sarcoma-associated herpesvirus (KSHV),also known as human herpesvirus 8 (HHV-8),is discovered in 1994 from Kaposi's sarcoma (KS) lesion of an acquired immunodeficiency syndrome (AIDS) patient. In addition t...Kaposi sarcoma-associated herpesvirus (KSHV),also known as human herpesvirus 8 (HHV-8),is discovered in 1994 from Kaposi's sarcoma (KS) lesion of an acquired immunodeficiency syndrome (AIDS) patient. In addition to its association with KS,KSHV has also been implicated as the causative agent of two other AIDS-associated malignancies: primary effusion lymphoma (PEL) and multicentric Castleman’s disease (MCD). KSHV is a complex DNA virus that not only has the ability to promote cellular growth and survival for tumor development,but also can provoke deregulated angiogenesis,inflammation,and modulate the patient’s immune system in favor of tumor growth. As KSHV is a necessary but not sufficient etiological factor for KS,human immunodeficiency virus (HIV) is a very important cofactor. Here we review the basic information about the biology of KSHV,development of pathogenesis and interaction between KSHV and HIV.展开更多
Although Kaposi sarcoma(KS) has been more traditionally considered an AIDS-defining illness,it may also be seen in individuals on immunosuppresive therapy.We report a case of a patient who presented to the hospital in...Although Kaposi sarcoma(KS) has been more traditionally considered an AIDS-defining illness,it may also be seen in individuals on immunosuppresive therapy.We report a case of a patient who presented to the hospital in the setting of increasingly refractory ulcerative colitis.Computed tomography scan of the abdomen was consistent with sigmoid diverticulititis and blood cultures were positive for Klebsiella.After a course of antibiotics with resolution of infection,a colonoscopy was performed to evaluate his diverticulitis and incidentally revealed a new rectal tumor.Immunohistochemistry showed the tumor was consistent with KS,with cells staining strongly positive for human herpesvirus-8.This case not only illustrates a rare case of KS found in an HIV-negative individual,but it also highlights the importance of considering an alternative diagnosis in a patient refractory to medical treatment.We discuss the management and care of an ulcerative colitis patient diagnosed with KS on immunosuppressive therapy.展开更多
Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease...Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.展开更多
Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individua...Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.展开更多
文摘Diffuse intestinal Kaposi's sarcoma shares macroscopicand histopathologic features with gastrointestinal stromatumors. Correct diagnosis may pose a clinical challengeWe describe the case of a young HIV-1-infected Africanlady without advanced immunodeficiency, who presentedwith a diffuse spindle cell tumor of the gut. Initiadiagnosis was of a gastrointestinal stromal tumor, basedon endoscopy and histopathology. Further evaluationrevealed evidence for human herpesvirus 8 (HHV8) andthe diagnosis had to be changed to diffuse intestinaKaposi's sarcoma. Antiretroviral triple therapy togethewith chemotherapy was commenced, and has led to therapid remission of intestinal lesions. With a backgroundof HIV infection, the presence of HHV8 as the causativeagent of Kaposi's sarcoma should be determined, asdistinct treatment is indicated.
文摘Background: HIV associated KS is relatively rare in children and has been reported to be higher in East Africa compared to other regions. Literature on cases of histologically proven Kaposi sarcoma in children with HIV infection in West Africa is scanty. Case presentation: This communication presents three cases of KS seen among children in a paediatric HIV unit. The first case was an eleven year old HIV positive boy who had oral candidiasis that resolved with treatment and subsequently developed a painless, erythematous swelling at the middle of the dorsum of the tongue with central loss of papillae. He also had multiple discoid hyperpigmented flat lesions on the legs and soles of the feet. In addition to switching to second line antiretroviral therapy, he had chemotherapy. The lesions regressed. The second case was a double orphan who had KS involvement of the right eye, nasal cavity and lymph nodes. The tumour rapidly progressed and the child died before ART and chemotherapy could be commenced. The last case was a five year old girl with mild KS of the skin but also had other manifestations of severe HIV disease which she succumbed to. Incisional biopsies of the lesions revealed an invasive epithelial lined vascular tumour destroying the upper layers of skeletal fibres within the connective tissue stroma in keeping with KS. Human Herpes Virus type 8 (HHV8) screen was also positive for all the cases. Conclusion: A high index of suspicion must be entertained and biopsy of suspicious muco-cutaneous lesions is necessary to exclude a diagnosis of KS which is an indicator of severity and progression of HIV.
基金Fok Ying Tung Education Foundation(101038)Program for New Century Excellent Talentsin Chinese Universities (NCET-05-0506)
文摘Kaposi sarcoma-associated herpesvirus (KSHV),also known as human herpesvirus 8 (HHV-8),is discovered in 1994 from Kaposi's sarcoma (KS) lesion of an acquired immunodeficiency syndrome (AIDS) patient. In addition to its association with KS,KSHV has also been implicated as the causative agent of two other AIDS-associated malignancies: primary effusion lymphoma (PEL) and multicentric Castleman’s disease (MCD). KSHV is a complex DNA virus that not only has the ability to promote cellular growth and survival for tumor development,but also can provoke deregulated angiogenesis,inflammation,and modulate the patient’s immune system in favor of tumor growth. As KSHV is a necessary but not sufficient etiological factor for KS,human immunodeficiency virus (HIV) is a very important cofactor. Here we review the basic information about the biology of KSHV,development of pathogenesis and interaction between KSHV and HIV.
文摘Although Kaposi sarcoma(KS) has been more traditionally considered an AIDS-defining illness,it may also be seen in individuals on immunosuppresive therapy.We report a case of a patient who presented to the hospital in the setting of increasingly refractory ulcerative colitis.Computed tomography scan of the abdomen was consistent with sigmoid diverticulititis and blood cultures were positive for Klebsiella.After a course of antibiotics with resolution of infection,a colonoscopy was performed to evaluate his diverticulitis and incidentally revealed a new rectal tumor.Immunohistochemistry showed the tumor was consistent with KS,with cells staining strongly positive for human herpesvirus-8.This case not only illustrates a rare case of KS found in an HIV-negative individual,but it also highlights the importance of considering an alternative diagnosis in a patient refractory to medical treatment.We discuss the management and care of an ulcerative colitis patient diagnosed with KS on immunosuppressive therapy.
文摘Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma.
文摘Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.
