Malignancies in the acquired immunodeficiency syndrome

Abstract

Malignancies frequently arise in patients infected with human immunodeficiency virus (HIV), including those patients classified as having the acquired immunodeficiency syndrome (AIDS). Currently, Kaposi's sarcoma and certain types of lymphoma are considered to develop as a result of HIV infection, and other cancers have also been reported in these patients. For the most part, ultrastructural study of HIV-associated malignancies has been limited to Kaposi's sarcoma; the ultrastructural features of the epidemic form of this disease are generally the same as those of the classical form. The occurrence of these cancers in HIV-infected individuals appears to be related to the immunodeficiency caused by this virus, but the basic etiologic mechanisms remain unknown. In general, only palliative treatments are presently available for HIV-associated malignancies.

Bowenoid Changes in Kaposi's Sarcoma

“…Bacteria, fungi, and mycobacteria were not detected with special stains and cultures. The histologic findings of this single lesion were consistent with Bowen's disease in the epidermis 1–4 and patch stage Kaposi's sarcoma in the dermis 7,8 …”

“…Kaposi's sarcoma is the most common malignancy associated with HIV infection 6–10 . Squamous cell carcinoma of the anus, rectum, and oral cavity has also been observed in HIV seropositive homosexual men, albeit less frequently 8‐10,13 .…”

“…Kaposi's sarcoma is the most common malignancy associated with HIV infection 6–10 . Squamous cell carcinoma of the anus, rectum, and oral cavity has also been observed in HIV seropositive homosexual men, albeit less frequently 8‐10,13 . Multiple or photodistributed squamous cell carcinomas and Bowen's disease located outside of the anogenital or oral areas have rarely been reported in HIV‐infected patients 14 .…”

“…Bowen's disease (squamous cell carcinoma in situ) is a premalignant dermatosis characterized clinically by an asymptomatic, scaly or crusted, erythematous plaque and histologically by atypical keratinocytes, multinucleated and dyskeratotic cells, and abnormal mitotic figures throughout the epidermis 1–5 . Epidemic acquired immunodeficiency syndrome‐ (AIDS) associated Kaposi's sarcoma predominantly occurs in homosexual men, has cutaneous and mucosal lesions of variable morphology and configuration that tend to be located along the lines of skin cleavage, and appears microscopically as a proliferation of spindle cells that form vascular channels that infiltrate between the collagen bundles of the dermk 6–10 . We describe a human immunodeficiency virus (HIV) seropositive man who not only had cutaneous lesions of Kaposi's sarcoma, but also a skin lesion in which both Bowenoid changes and Kaposi's sarcoma coexisted.…”