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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

Lymphoepithelial carcinoma of the parotid gland.  (a) Medium power view demonstrating the association between the high grade neoplasm and the parotid acini (H&E stain, 100x magnification).  (b)  High power view showing the highly atypical epithelial cells with irregular vesicular nuclei and prominent nucleoli (H&E stain, 400x magnification). (c) A cytokeratin AE1 and AE3 highlighting the high grade epithelial cells (200x magnification). (d) EBER in situ hybridization demonstrating strong diffuse nuclear reactivity. Image courtesy of Dr. E. Leon Barnes (400x magnification).
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fig4: Lymphoepithelial carcinoma of the parotid gland. (a) Medium power view demonstrating the association between the high grade neoplasm and the parotid acini (H&E stain, 100x magnification). (b) High power view showing the highly atypical epithelial cells with irregular vesicular nuclei and prominent nucleoli (H&E stain, 400x magnification). (c) A cytokeratin AE1 and AE3 highlighting the high grade epithelial cells (200x magnification). (d) EBER in situ hybridization demonstrating strong diffuse nuclear reactivity. Image courtesy of Dr. E. Leon Barnes (400x magnification).

Mentions: Histologically, the malignant cells of LEC are arranged in infiltrative sheets and islands with abundant lymphoid stroma consisting of polymorphous lymphocytes and plasma cells (see Figure 4). Tumor cells have indistinct borders with pale eosinophilic cytoplasm and variable vesicular nuclei with prominent nucleoli. Apart from NPC, other malignant entities to consider in the differentiation include malignant lymphoma and undifferentiated carcinoma. Mitoses are common in LEC and so are necrotic foci. Focal squamous differentiation can be seen. Less common features include noncaseating granulomas, multinucleated giant cells, amyloid and cystic structures. Perineural and angiolymphatic invasion may be seen. The tumor cells are immunoreactive for pancytokeratin and epithelial membrane antigen (EMA). Salivary gland LEC arising in endemic areas typically demonstrate positivity for EBER (see Figure 4).


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)

Lymphoepithelial carcinoma of the parotid gland.  (a) Medium power view demonstrating the association between the high grade neoplasm and the parotid acini (H&E stain, 100x magnification).  (b)  High power view showing the highly atypical epithelial cells with irregular vesicular nuclei and prominent nucleoli (H&E stain, 400x magnification). (c) A cytokeratin AE1 and AE3 highlighting the high grade epithelial cells (200x magnification). (d) EBER in situ hybridization demonstrating strong diffuse nuclear reactivity. Image courtesy of Dr. E. Leon Barnes (400x magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig4: Lymphoepithelial carcinoma of the parotid gland. (a) Medium power view demonstrating the association between the high grade neoplasm and the parotid acini (H&E stain, 100x magnification). (b) High power view showing the highly atypical epithelial cells with irregular vesicular nuclei and prominent nucleoli (H&E stain, 400x magnification). (c) A cytokeratin AE1 and AE3 highlighting the high grade epithelial cells (200x magnification). (d) EBER in situ hybridization demonstrating strong diffuse nuclear reactivity. Image courtesy of Dr. E. Leon Barnes (400x magnification).
Mentions: Histologically, the malignant cells of LEC are arranged in infiltrative sheets and islands with abundant lymphoid stroma consisting of polymorphous lymphocytes and plasma cells (see Figure 4). Tumor cells have indistinct borders with pale eosinophilic cytoplasm and variable vesicular nuclei with prominent nucleoli. Apart from NPC, other malignant entities to consider in the differentiation include malignant lymphoma and undifferentiated carcinoma. Mitoses are common in LEC and so are necrotic foci. Focal squamous differentiation can be seen. Less common features include noncaseating granulomas, multinucleated giant cells, amyloid and cystic structures. Perineural and angiolymphatic invasion may be seen. The tumor cells are immunoreactive for pancytokeratin and epithelial membrane antigen (EMA). Salivary gland LEC arising in endemic areas typically demonstrate positivity for EBER (see Figure 4).

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