bromochloroacetic-acid and Acquired-Immunodeficiency-Syndrome

Six cases of squamous cell carcinoma arising in the head and neck of patients infected with the human immunodeficiency virus are described. This article reports the first two cases of primary intraosseous squamous cell carcinoma associated with infection with human immunodeficiency virus. Clinical presentation, results of imaging studies, histologic characteristics, therapies applied, and the clinical follow-up are described in detail for each of the six cases. These data are evaluated through a review of the current literature.

Topics: Acquired Immunodeficiency Syndrome; Adult; Biomarkers, Tumor; Carcinoma, Squamous Cell; CD4-CD8 Ratio; Female; Head and Neck Neoplasms; HIV Infections; Humans; Immunocompromised Host; Keratins; Male; Mandibular Neoplasms; Middle Aged; Mouth Neoplasms

Fibrosing alveolitis is a usually chronic pulmonary disease affecting middle-aged men and women and causing progressive dyspnea. This review discusses the nosologic, etiologic, immunopathogenic, histologic, immunohistochemical and ultrastructural features of this condition. A hypothesis is presented suggesting microvascular damage as the primary pathologic change in cases associated with collagen vascular diseases and viral pneumonia.

Topics: Acquired Immunodeficiency Syndrome; Biopsy; Female; Fibronectins; Growth Substances; Histocytochemistry; Humans; Interferon Type I; Keratins; Lung; Male; Microcirculation; Microscopy, Electron; Molecular Weight; Pleura; Pulmonary Fibrosis; T-Lymphocytes

Kaposi's Sarcoma (KS) is a proliferation of aberrant vascular structures lined by spindle cells, and is caused by a gammaherpes virus (HHV8/KSHV). Its course is aggravated by co-infection with HIV-1, where the timing of infection with HIV-1 and HHV8 is important for the clinical outcome.. In order to better understand the pathogenesis of KS, we have analysed tissue from two AIDS-KS lesions, and from normal skin by serial analysis of gene expression (SAGE). Semi-quantitative RT-PCR was then used to validate the results.. The expression profile of AIDS-related KS (AIDS-KS) reflects an active process in the skin. Transcripts of HHV8 were found to be very low, and HIV-1 mRNA was not detected by SAGE, although it could be found using RT-PCR. Comparing the expression profile of AIDS-KS tissue with publicly available SAGE libraries suggested that AIDS-KS mRNA levels are most similar to those in an artificially mixed library of endothelial cells and leukocytes, in line with the description of KS lesions as containing spindle cells with endothelial characteristics, and an inflammatory infiltrate. At least 64 transcripts were found to be significantly elevated, and 28 were statistically downregulated in AIDS-KS compared to normal skin. Five of the upregulated mRNAs, including Tie 1 and sialoadhesin/CD169, were confirmed by semi-quantitative PCR to be elevated in additional AIDS-KS biopsies. Antibodies to sialoadhesin/CD169, a known marker of activated macrophages, were shown to specifically label tumour macrophages.. The expression profile of AIDS-KS showed 64 genes to be significantly upregulated, and 28 genes downregulated, compared with normal skin. One of the genes with increased expression was sialoadhesin (CD169). Antibodies to sialoadhesin/CD169 specifically labelled tumour-associated macrophages, suggesting that macrophages present in AIDS-KS lesions belong to a subset of human CD169+ macrophages.

Topics: Acquired Immunodeficiency Syndrome; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Galectins; Gene Expression Profiling; Herpesvirus 8, Human; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Receptors, Immunologic; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Sarcoma, Kaposi; Sialic Acid Binding Ig-like Lectin 1; Skin

Lymphadenopathy in the human immunodeficiency virus (HIV) can be of diverse etiology, ranging from infection to cancer. A neoplasm of epithelial origin manifested as inguinal lymphadenopathy without a primary lesion is rare. We report a case of Merkel cell tumor confined only to a lymph node in a patient with the acquired immunodeficiency syndrome (AIDS). We believe this is the first report of primary nodal Merkel cell tumor in a patient with HIV. Because Merkel cell tumor is a rare skin neoplasm with features suggestive of high malignant potential, it is important to distinguish a primary nodal Merkel cell tumor from malignant metastatic processes on the one hand and relatively benign causes of adenopathy on the other.

Topics: Acquired Immunodeficiency Syndrome; Adult; Axilla; Carcinoma, Merkel Cell; Chromogranins; Follow-Up Studies; HIV Infections; Humans; Inguinal Canal; Keratins; Lymph Nodes; Lymphatic Diseases; Male; Phosphopyruvate Hydratase; Synaptophysin

A novel approach is presented to assess the ability of thymic tissues obtained from children with end stage AIDS to attract normal bone marrow (BM)-derived CD34+ (lineage negative) stem cells (SCs) and support lymphopoiesis in vitro. Chemokinesis of BM-derived CD34+ SCs was analyzed by time-lapse videomicroscopy to ascertain whether an alteration in SC motility could contribute to abnormal thymopoiesis under conditions of HIV infection. The migration of SCs derived from an HIV+ donor into thymic tissue was not significantly altered compared to normal controls, as were normal SCs migrating toward thymic epithelial cell monolayers derived from an HIV+ patient. Thymic tissue obtained from children with AIDS contained nests of CD34+ SCs identified by immunofluorescence, indicating SC homing to the thymus is apparently supported in HIV infection. The ability of HIV-affected thymic epithelial fragments to support lymphopoiesis was determined by examining the initial thymocyte populations present, compared to thymocytes produced de novo in T cell-depleted thymic fragments, following a single pulse of lineage negative CD34+ CD38- SCs. In comparison to normal controls, thymocytes derived from the HIV-affected thymic epithelial fragment coculture had an increased percentage of triple negative thymocytes (28% of lymphocytes from HIV-affected tissue versus 1.5% in controls, p < 0.01) and a decreased percentage of double and single positive CD4+ thymocytes. However, CD3+CD8+ TCR alpha beta + expression was comparable to control cultured thymic epithelial fragments indicating that HIV-affected thymic epithelia were capable of supporting the development of the CD8+ lineage. In an effort to extend the information obtained to date from the histological examination of HIV-affected thymic tissue, select patient thymic tissues were maintained in culture to evaluate the capacity of undifferentiated thymic epithelial cell guirlandes to differentiate in vitro. A partial regeneration of certain subpopulations of the thymic epithelium defined by TE-4 monoclonal antibody (mAb) and CDR2 mAbs occurred during the in vitro culture. The epithelial and mesenchymal components of thymic tissues were distinguished by immunostaining for keratins (indicative of epithelium) and vimentin (a mesenchymal marker). Further evaluation of the modulation of HIV thymus, with respect to the testing of new therapeutic strategies on SCs, will be possible with this in vitro model.

Topics: Acquired Immunodeficiency Syndrome; ADP-ribosyl Cyclase; ADP-ribosyl Cyclase 1; Antigens, CD; Antigens, CD34; Antigens, Differentiation; Bone Marrow; Bone Marrow Cells; Cell Differentiation; Cell Lineage; Cell Movement; Cells, Cultured; Child; Epithelial Cells; Fluorescent Antibody Technique; Hematopoiesis; Hematopoietic Stem Cells; Humans; Immunophenotyping; Keratins; Membrane Glycoproteins; Microscopy, Confocal; Microscopy, Video; N-Glycosyl Hydrolases; T-Lymphocytes; Thymus Gland; Vimentin

Eccrine (sweat gland) carcinoma is a rare form of skin cancer that may be locally destructive. It is known to recur after resection and can metastasize to regional or distant lymph nodes. There have been two reported cases in association with patients immunocompromised as the result of organ transplantation (I. Penn: Prog Allergy. 37: 259, 1986). We report here the first case of sweat gland carcinoma in a patient infected with the human immunodeficiency virus.

Topics: Acquired Immunodeficiency Syndrome; Adenocarcinoma; Carcinoembryonic Antigen; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Skin Neoplasms

We report twenty-five patients with the acquired immunodeficiency syndrome (AIDS) and interface dermatitis. Patients with AIDS and interface dermatitis had numerous opportunistic and herpetic infections. Nearly all patients were receiving at least one medication prior to the development of their rash and many were clinically thought to have a drug eruption. When compared to skin biopsy specimens from non-AIDS patients with drug eruptions, specimens from patients with AIDS and interface dermatitis demonstrated a greater degree of vacuolar change, the frequent occurrence of necrotic keratinocytes, often in clumps, and the absence of eosinophils and polymorphonuclear leukocytes in the dermal infiltrates. Histologic and clinical features of our patients with AIDS and interface dermatitis are presented and contrasted with other interface dermatitides. Systemic and cutaneous immune abnormalities in patients with AIDS may be relevant to the pathogenesis of this interface process.

Topics: Acquired Immunodeficiency Syndrome; Adult; Biopsy; Dermatitis; Epidermal Cells; Female; Humans; Keratins; Male; Neutrophils; Skin; Vacuoles

Thirty biopsies of oral mucosal lesions and normal oral mucosa were obtained from 26 HIV-seropositive individuals and studied for virus infections with Epstein-Barr virus-specific DNA probes (EBV). In situ DNA hybridization was carried out on frozen and formalin-fixed, paraffin-embedded tissues. Specifically bound biotinylated virus probes were detected with the streptavidin-gold-silver technique and visualized by standard and interference reflection microscopy. In 9/30 biopsies, EBV DNA was clearly demonstrated in the upper two thirds of oral epithelia. This finding corresponded to peculiar cytopathic effects including ground glass nuclei, basophilic nuclear inclusions, and ballooning of the cytoplasm, which were concentrated in the upper two or three layers of the stratum spinosum. Cytopathic effects together with the demonstration of EBV DNA were demonstrated in seven cases of tongue mucosa, and two cases derived from the gingiva. When comparing clinical and pathological findings with DNA detection rates, we saw 5/9 hairy leukoplakias associated with EBV infections. Four positive cases (two samples from the tongue, two gingival specimens) had not been regarded as hairy leukoplakia clinically. EBV infection of the oral epithelium occurred in male homosexuals (7 cases) and in male/female intravenous drug abusers (2 cases). Among the nine EBV-positive cases, 2 patients were asymptomatic, 4 patients were grouped into the ARC-, and 3 individuals into the AIDS-category. We conclude that HIV-seropositive patients are particularly prone to develop productive EBV infections in oral epithelia. This infection most frequently appears at the lateral border of the tongue, but may also occur at other sites of the oral cavity, and may already exist in a preclinical stage prior to the development of oral white lesions (hairy leukoplakia).

Topics: Acquired Immunodeficiency Syndrome; AIDS-Related Complex; Biopsy; DNA; DNA, Viral; Herpesvirus 4, Human; Humans; Keratins; Leukoplakia, Oral; Mouth Mucosa; Nucleic Acid Hybridization