Benign and malignant neoplasias in 261 necropsies for HIV-positive patients in the period of 1989 to 2008

Abstract

Considering that there are some studies with autopsies from AIDS describing only malignant neoplasias and that changes can occur after the introduction of Highly Active Antiretroviral Therapy (HAART), our objectives were to analyze the frequency of benign and malignant neoplasms in AIDS patients in the periods of both pre- and post-HAART. This is a retrospective study with 261 autopsies of HIV-positive patients between 1989 and 2008 in Uberaba, Brazil. Sixty-six neoplasms were found (39 benign, 21 malignant and six premalignant) in 58 patients. The most frequent malignant neoplasms were lymphoid, in 2.7% (four Non-Hodgkin lymphoma, one Hodgkin, one multiple myeloma and one plasmablastic plasmacytoma), and Kaposi's Sarcoma, in 2.3% (six cases). The most frequent benign neoplasms were hepatic hemangiomas in 11 (4.2%) of 261 cases and uterine leiomyoma in 11 (15.7%) of 70 woman. In the pre-HAART period eight (9.8%) benign neoplasias and four (4.9%) malignant occurred in 82 patients; in the post-HAART period, 29 (16.2%) benign and 17 (9.5%) malignant were present; however, the differences were not significant. We conclude that the introduction of HAART in our region doesn't look to have modified the frequency of neoplasms occurring in patients with HIV.

Morphological changes in the digestive system of 322 necropsies of patients with acquired immune deficiency syndrome: comparison of findings pre- and post-HAART (Highly Active Antiretroviral Therapy)

“…None of the other malignancies found (3 GIST, 3 carcinomas - 1 gastric adenocarcinoma cells in signet ring, 1 metastatic undifferentiated carcinoma of the testis, 1 rectal squamous cell carcinoma) are considered to be related to AIDS. The low incidence of malignancies also occurred in other necropsy studies, not only in Brazil 3 , 29 , 34 , 35 , but also in foreign studies that analyzed necropsy and biopsy samples 9 , 21 . …”

Abdominal neoplasia with sarcomatoid features as the presenting illness of a patient with a newly diagnosed HIV infection and no AIDS-related disorders. Case report, clinical and diagnostic features, and literature discussion

“…In particular, malignancies which are frequent in the general population often present with a clinical pathomorphism in our patient population, as in a case of atypical prostate cancer [8], and in some anecdotal presentations of Merkel cell carcinoma [9], and bladder and gastric cancer, respectively [10,11]. Very frequent associations with opportunistic and non-opportunistic disorders complicate even considerably the differential diagnostic pathway in multiple described case reports [1,2,6,7,12], in particular two cases of nasopharyngeal and rhinopharyngeal carcinoma [12].…”

“…Neoplasia with sarcomatoid features as the presenting illness of a patient with a newly diagnosed HIV disease ing HIV infection itself (i.e. HBV, HCV, HPV, HSV, HHV-8, and EBV infections, among others), and a persisting immune system functional imbalance favoring the onset of tumors, in comparison with an epidemiologically matched sample of general population, which is not harboring HIV infection [2][3][4][5]7].…”

Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study

“…UL prevalence has been evaluated by different methods, such as population surveys,17 pathologic study of surgical specimens of hysterectomy,18 postmortem of women who died without gynecological diseases,19 and pelvic ultrasonography,13,20,21 with, as expected, different results.…”