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A Review of Carcinomas Arising in the Head and Neck Region in HIV-Positive Patients.

Purgina B, Pantanowitz L, Seethala RR - Patholog Res Int (2011)

Bottom Line: Data also suggest that HIV-positive patients with these cancers present at a younger age, with more aggressive disease and worse prognosis compared to HIV-negative patients.Treatment involves surgical resection with or without radiation therapy and chemotherapy for locally advanced and metastatic disease.AIDS patients, however, are more likely to suffer radiation treatment complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Presbyterian-Shadyside University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.

ABSTRACT
The majority of malignancies arising in the head and neck among patients with AIDS are Kaposi sarcoma and non-Hodgkin lymphoma. Patients with HIV/AIDS are also at increased risk of developing several carcinomas of the head and neck. This paper focuses on these less common, albeit important, carcinomas. An English language literature search identified numerous population-based studies evaluating carcinomas in the head and neck of HIV-positive patients. Published results indicate that patients with HIV/AIDS are at an increased risk of developing mucosal squamous cell carcinoma, nasopharyngeal carcinoma, lymphoepithelial carcinoma of the salivary gland, and Merkel cell carcinoma in this anatomic region. Data also suggest that HIV-positive patients with these cancers present at a younger age, with more aggressive disease and worse prognosis compared to HIV-negative patients. Treatment involves surgical resection with or without radiation therapy and chemotherapy for locally advanced and metastatic disease. AIDS patients, however, are more likely to suffer radiation treatment complications. Highly active antiretroviral therapy (HAART) has not altered the incidence of these malignancies.

No MeSH data available.


Related in: MedlinePlus

(a) and (b) Squamous cell carcinoma in situ of the conjunctiva in a 43-year-old HIV-positive man.  ((a) hematoxylin & eosin (H&E) stain, 100x magnification; (b) H&E stain, 400x magnification). (c) and (d) Ulcerated (c) invasive moderately differentiated squamous cell carcinoma of the tongue and infiltrating among skeletal muscle bands (d) in a 54-year-old HIV-positive man ((c) H&E stain, 100x magnification; (d) H&E stain, 200x magnification).
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fig1: (a) and (b) Squamous cell carcinoma in situ of the conjunctiva in a 43-year-old HIV-positive man. ((a) hematoxylin & eosin (H&E) stain, 100x magnification; (b) H&E stain, 400x magnification). (c) and (d) Ulcerated (c) invasive moderately differentiated squamous cell carcinoma of the tongue and infiltrating among skeletal muscle bands (d) in a 54-year-old HIV-positive man ((c) H&E stain, 100x magnification; (d) H&E stain, 200x magnification).

Mentions: The histopathologic features of SCCs arising in the head and neck range from well differentiated tumor with obvious squamous differentiation and keratinization to poorly differentiated carcinomas lacking keratinization (see Figure 1). Keratinizing carcinomas are more typical of the oral cavity and larynx, whereas nonkeratinizing morphology is seen more commonly in the oropharynx, the latter of which is associated with HPV (see Figure 2). While several morphologic variants of SCC (e.g., verrucous, basaloid, and spindle cell carcinoma) exist, these have not been documented to have a different incidence in the setting of HIV as compared to the general population. A recent study by McLemore et al. [27] described the presence of multinucleated tumor giant cells in 39 of 40 head and neck SCC arising in patients with HIV/AIDS. This feature has not been previously reported. We reviewed cases of mucosal SCC in HIV-positive patients from our institution and also identified these multinucleated tumor giant cells (see Figure 3). Otherwise, the morphologic features of SCCs in HIV patients are not particularly distinct despite the aggressive clinical behavior in this setting.


A Review of Carcinomas Arising in the Head and Neck Region in HIV-Positive Patients.

Purgina B, Pantanowitz L, Seethala RR - Patholog Res Int (2011)

(a) and (b) Squamous cell carcinoma in situ of the conjunctiva in a 43-year-old HIV-positive man.  ((a) hematoxylin & eosin (H&E) stain, 100x magnification; (b) H&E stain, 400x magnification). (c) and (d) Ulcerated (c) invasive moderately differentiated squamous cell carcinoma of the tongue and infiltrating among skeletal muscle bands (d) in a 54-year-old HIV-positive man ((c) H&E stain, 100x magnification; (d) H&E stain, 200x magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108450&req=5

fig1: (a) and (b) Squamous cell carcinoma in situ of the conjunctiva in a 43-year-old HIV-positive man. ((a) hematoxylin & eosin (H&E) stain, 100x magnification; (b) H&E stain, 400x magnification). (c) and (d) Ulcerated (c) invasive moderately differentiated squamous cell carcinoma of the tongue and infiltrating among skeletal muscle bands (d) in a 54-year-old HIV-positive man ((c) H&E stain, 100x magnification; (d) H&E stain, 200x magnification).
Mentions: The histopathologic features of SCCs arising in the head and neck range from well differentiated tumor with obvious squamous differentiation and keratinization to poorly differentiated carcinomas lacking keratinization (see Figure 1). Keratinizing carcinomas are more typical of the oral cavity and larynx, whereas nonkeratinizing morphology is seen more commonly in the oropharynx, the latter of which is associated with HPV (see Figure 2). While several morphologic variants of SCC (e.g., verrucous, basaloid, and spindle cell carcinoma) exist, these have not been documented to have a different incidence in the setting of HIV as compared to the general population. A recent study by McLemore et al. [27] described the presence of multinucleated tumor giant cells in 39 of 40 head and neck SCC arising in patients with HIV/AIDS. This feature has not been previously reported. We reviewed cases of mucosal SCC in HIV-positive patients from our institution and also identified these multinucleated tumor giant cells (see Figure 3). Otherwise, the morphologic features of SCCs in HIV patients are not particularly distinct despite the aggressive clinical behavior in this setting.

Bottom Line: Data also suggest that HIV-positive patients with these cancers present at a younger age, with more aggressive disease and worse prognosis compared to HIV-negative patients.Treatment involves surgical resection with or without radiation therapy and chemotherapy for locally advanced and metastatic disease.AIDS patients, however, are more likely to suffer radiation treatment complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Presbyterian-Shadyside University Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.

ABSTRACT
The majority of malignancies arising in the head and neck among patients with AIDS are Kaposi sarcoma and non-Hodgkin lymphoma. Patients with HIV/AIDS are also at increased risk of developing several carcinomas of the head and neck. This paper focuses on these less common, albeit important, carcinomas. An English language literature search identified numerous population-based studies evaluating carcinomas in the head and neck of HIV-positive patients. Published results indicate that patients with HIV/AIDS are at an increased risk of developing mucosal squamous cell carcinoma, nasopharyngeal carcinoma, lymphoepithelial carcinoma of the salivary gland, and Merkel cell carcinoma in this anatomic region. Data also suggest that HIV-positive patients with these cancers present at a younger age, with more aggressive disease and worse prognosis compared to HIV-negative patients. Treatment involves surgical resection with or without radiation therapy and chemotherapy for locally advanced and metastatic disease. AIDS patients, however, are more likely to suffer radiation treatment complications. Highly active antiretroviral therapy (HAART) has not altered the incidence of these malignancies.

No MeSH data available.


Related in: MedlinePlus