Limits...
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) Low-power view of Merkel cell carcinoma arising in a transplant patient.  Note the hypercellular proliferation of small blue cells within the dermis (H&E stain, 40x magnification). (b) A cytokeratin stain (CAM5.2) demonstrating strong diffuse cytoplasmic staining (400x magnification). (c) Perinuclear positivity is seen with cytokeratin 20 (400x magnification). (d) Synaptophysin demonstrates diffuse cytoplasmic staining.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3108450&req=5

fig6: (a) Low-power view of Merkel cell carcinoma arising in a transplant patient. Note the hypercellular proliferation of small blue cells within the dermis (H&E stain, 40x magnification). (b) A cytokeratin stain (CAM5.2) demonstrating strong diffuse cytoplasmic staining (400x magnification). (c) Perinuclear positivity is seen with cytokeratin 20 (400x magnification). (d) Synaptophysin demonstrates diffuse cytoplasmic staining.

Mentions: The histologic features of MCC in immunocompromised and immunocompetent are identical, with hypercellular areas composed of “small blue cells” with indistinct cytoplasmic borders, hyperchromatic nuclei with indistinct nucleoli and numerous mitotic and apoptotic bodies scattered throughout the tumor (see Figure 6). Angiolymphatic invasion and surface ulceration may be seen [63]. MCC must be distinguished from other small round blue cell tumors such as small cell carcinoma of the lung and lymphoma. MCC demonstrates immunoreactivity for both neuroendocrine markers (neuron specific enolase, synaptophysin and chromogranin) and cytokeratins (cytokeratin 20 and CAM5.2) (see Figure 6). Paranuclear dot-like positivity with cytokeratin 20 is useful diagnostic feature (see Figure 6). MCC is negative for TTF-1, cytokeratin 7 and LCA which help to distinguish this neuroendocrine tumor from small cell carcinoma of the lung and lymphoma. Many cases of MCC may demonstrate CD117 (c-kit) positivity, however this has not been associated with improved outcome [63, 66]. Thus far, no c-kit-activating mutations have been identified [66].


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) Low-power view of Merkel cell carcinoma arising in a transplant patient.  Note the hypercellular proliferation of small blue cells within the dermis (H&E stain, 40x magnification). (b) A cytokeratin stain (CAM5.2) demonstrating strong diffuse cytoplasmic staining (400x magnification). (c) Perinuclear positivity is seen with cytokeratin 20 (400x magnification). (d) Synaptophysin demonstrates diffuse cytoplasmic staining.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig6: (a) Low-power view of Merkel cell carcinoma arising in a transplant patient. Note the hypercellular proliferation of small blue cells within the dermis (H&E stain, 40x magnification). (b) A cytokeratin stain (CAM5.2) demonstrating strong diffuse cytoplasmic staining (400x magnification). (c) Perinuclear positivity is seen with cytokeratin 20 (400x magnification). (d) Synaptophysin demonstrates diffuse cytoplasmic staining.
Mentions: The histologic features of MCC in immunocompromised and immunocompetent are identical, with hypercellular areas composed of “small blue cells” with indistinct cytoplasmic borders, hyperchromatic nuclei with indistinct nucleoli and numerous mitotic and apoptotic bodies scattered throughout the tumor (see Figure 6). Angiolymphatic invasion and surface ulceration may be seen [63]. MCC must be distinguished from other small round blue cell tumors such as small cell carcinoma of the lung and lymphoma. MCC demonstrates immunoreactivity for both neuroendocrine markers (neuron specific enolase, synaptophysin and chromogranin) and cytokeratins (cytokeratin 20 and CAM5.2) (see Figure 6). Paranuclear dot-like positivity with cytokeratin 20 is useful diagnostic feature (see Figure 6). MCC is negative for TTF-1, cytokeratin 7 and LCA which help to distinguish this neuroendocrine tumor from small cell carcinoma of the lung and lymphoma. Many cases of MCC may demonstrate CD117 (c-kit) positivity, however this has not been associated with improved outcome [63, 66]. Thus far, no c-kit-activating mutations have been identified [66].

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