Sarcoma de Kaposi en el recto, reporte de un caso / Kaposi´s sarcoma in the rectum: case report

En 1872, el dermatólogo austro-húngaro Moritz Kaposi describió -por primera vez- esta enfermedad clínica y la llamó Sarcoma Múltiple Pigmentado Idiopático, que afecta a varones judíos y de áreas mediterráneas. En 1956 describieron una variedad endémica en África ecuatorial. En la década de los 60 se describió una tercera variedad en pacientes sometidos a trasplante renal e inmunodeprimidos. En la década de los 80 se comunicaron los primeros casos asociados al Virus de la Inmunodeficiencia Humana. Caso clínico: Se presentó el caso de un paciente portador del Virus de la Inmunodeficiencia Humana que fue atendido en el Hospital Carlos Andrade Marín de la ciudad de Quito, por presentar lesiones exofíticas distribuidas en la región inguinal, genital y ano-perineal, con secreción amarillenta de mal olor, edema de la bolsa escrotal y del muslo derecho. El diagnosticó fue Sarcoma de Kaposi asociada al virus de Inmunodeficiencia Humana. La evolución desfavorable y el estadio avanzado de la enfermedad provocaron la muerte del paciente. Discusión: El Sarcoma de Kaposi (SK) es una neoplasia maligna vascular, más frecuente en pacientes inmunocomprometidos, conlleva una alta morbilidad y mortalidad. El diagnóstico requiere una confirmación histológica de la celularidad neoplásica y la presencia del VHH-8.

In 1872 the Austro Hungarian dermatologist Moritz Kaposi described this clinical entity for the first time and called Idiopathic Pigmented Multiple Sarcoma that affected male Jews from Mediterranean areas. In 1956 an endemic variety in equatorial Africa was reported. In the 1960s, a third variety was described in patients undergoing renal transplantation and receiving immunosuppression. In the 80s appeared in patients infected with the Human Immunodeficiency Virus. Case report: The case of a patient previously diagnosed as a carrier of human immunodeficiency virus treated at Carlos Andrade Marín Hospital, Quito Ecuador, for having exophytic lesions distributed in the inguinal, genital and ano-perineal regions, with a fetid yellowish discharge, scrotal and right thigh edema. A diagnosis of Kaposi's sarcoma associated to acquired immunodeficiency virus was made. After an unsatisfactory evolution and due to the advanced stage of the disease, the patient died. Discussion: Kaposi's Sarcoma (KS) is a malignant vascular neoplasm, more frequent in immunocompromised patients. It has a high morbidity and mortality. The diagnosis requires histological confirmation of neoplastic cellularity and the presence of HHV-8.

Oral plasmablastic lymphoma as the first manifestation of AIDS

Abstract Plasmablastic lymphoma is a non-Hodgkin lymphoma characterized by its plasmacytic differentiation and predilection for the oral cavity. It is among the lymphomas most commonly associated with AIDS. This report details a case of a HIV-positive patient with a 1-month history of an exophytic mass in the gingival area of the upper left quadrant. The diagnosis of plasmablastic lymphoma was made based on its histopathological and immunophenotypical features. She was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Despite complete resolution of the lesion, the patient died of cardiorespiratory arrest. This case illustrates plasmablastic lymphoma as the first clinical manifestation of AIDS, highlighting the importance of differentiating between a potentially malignant lesion and other pathologic processes.

Linfoma esofágico primário / Primary esophageal lymphoma

We describe the case of a 54 year old woman seen with an esophageal mass diagnosed as a primary esophageal lymphoma. The main symptom was dysphagia of seven months duration. The treatment consisted in resection of the tumor, and reconstruction of the defect with a reversed pleural flap, followed by a chemotherapy regimen that consisted of five drugs, cyclophosphamid, prednisone, doxorubicin, rituximab and vincristine (R-CHOP). The patient developed an esophageal pleural fistula treated with pleural drainage and irrigation that closed in 45 days. Two and one half years later she is doing well and disease free.

A clinical analysis of AIDS-related non-Hodgkin lymphoma in 5 patients and review of literature / 中华内科杂志

Objective To analyze the clinical characteristics of AIDS-related non-Hodgkin lymphoma(ARL)and review relative literature for the diagnosis and treatment of ARL.Method The clinical data of ARL patients admitted to Peking Union Medical College Hospital from April 2009 to April 2011 were retrospectively analyzed.Results Five male ARL patients aged 32 to 65 years old were included in this retrospective study.Among them,two patients were found to be HIV-positive for the first time,three were on regular highly active anti-retroviral therapy(HAART)for 7-8 months before the emergence of lymphoma-related symptoms.CD4+ T cell count was(69-232)× 106/L at presentation.Two patients firstly presented with sore throat and throat ulcer,one with cervical nodules,one with pelvic mass,one with fever and edema in right thigh.Through pathological analysis,four patients had B cell-originated lymphoma,with one Burkitt lymphoma and three diffuse large B cell lymphomas; one patient had T-cell lymphoma.Four patients were treated with chemotherapy,with one complete remission,one relapse,one non-response,and one death.One patient had radiotherapy only and had progressed disease.Bone marrow suppression and gastrointestinal disturbance were the main adverse effects of chemotherapy.Conclusions Lymphoma should be considered in any HIV-infected patients presented with unexplainable adenopathy,recurrent sore throat or throat ulcer,or fever of unknown origin.Biopsy should be rigorously carried out.Appropriate chemotherapy,together with HAART,may improve the prognosis greatly.