Back to Search
Start Over
Cutaneous Colesional Acquired Immunodeficiency Syndrome Associated Kaposi Sarcoma and Cryptococcosis
- Source :
- The American Journal of Dermatopathology. 32:780-786
- Publication Year :
- 2010
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2010.
-
Abstract
- The clinicopathologic features of 4 AIDS patients with cutaneous colesional Kaposi sarcoma (KS) and cryptococcosis, a rare phenomenon, are described. Biopsies from 3 patients who were highly active antiretroviral therapy (HAART)-naive demonstrated predominant KS with a conspicuous spindle cell component and small aggregates of cryptococcal yeasts in 2 biopsies and predominant gelatinous cryptococcosis with attenuated KS spindle cells in 1 biopsy. One patient was HAART exposed. He had childhood pulmonary tuberculosis, was treated for disseminated cutaneous cryptococcosis 18 months earlier and presented with cutaneous lesions, odynophagia and massive cervical lymphadenopathy in the eighth week of HAART, after achieving viral suppression and a CD4 cell increase from 28 to 184 cells/μL. His skin biopsy demonstrated a dense lymphoplasmacytic infiltrate, neutrophils, and granulomas with admixed aggregates and single Cryptococcus neoformans and focal aggregation of human herpes virus 8-immunopositive spindle cells. Acid fast bacilli were not identified and mycobacterial molecular studies were negative. The features were compatible with cutaneous cryptococcal immune reconstitution inflammatory syndrome. His nodal and oropharyngeal biopsies demonstrated dense mixed, including granulomatous, inflammation with few cryptococcal yeasts and acid fast bacilli, confirmed to be Mycobacterium tuberculosis on polymerase chain reaction testing, without KS. These features were also compatible with immune reconstitution inflammatory syndrome, but the exact role of each infection in the extracutaneous sites was unconfirmed. Colesional KS and cryptococcosis served as the sentinel lesion of AIDS in 3 patients and of immune reconstitution inflammatory syndrome in 1 patient.
- Subjects :
- Adult
Male
Pathology
medicine.medical_specialty
Antifungal Agents
Skin Neoplasms
Biopsy
Dermatology
Pathology and Forensic Medicine
Young Adult
Immune reconstitution inflammatory syndrome
Immune Reconstitution Inflammatory Syndrome
Cervical lymphadenopathy
Antiretroviral Therapy, Highly Active
Immunopathology
medicine
Dermatomycoses
Humans
Sarcoma, Kaposi
Mycosis
Skin
Cryptococcus neoformans
Acquired Immunodeficiency Syndrome
biology
medicine.diagnostic_test
business.industry
Cryptococcosis
General Medicine
Middle Aged
biology.organism_classification
medicine.disease
Treatment Outcome
Immunology
Skin biopsy
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 01931091
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- The American Journal of Dermatopathology
- Accession number :
- edsair.doi.dedup.....814b55dfaac2e528a590fc78b43eb006