| Cutaneous colesional acquired immunodeficiency syndrome associated kaposi sarcoma and cryptococcosis. | |
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MedLine Citation:
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PMID: 20802305 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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Pratistadevi K Ramdial; Yetish Sing; Sumeshini Subrayan; Eduardo Calonje |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American Journal of dermatopathology Volume: 32 ISSN: 1533-0311 ISO Abbreviation: Am J Dermatopathol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7911005 Medline TA: Am J Dermatopathol Country: United States |
Other Details:
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Languages: eng Pagination: 780-6 Citation Subset: IM |
Affiliation:
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Department of Anatomical Pathology, University of KwaZulu Natal, Durban, KwaZulu Natal, South Africa. ramdial@ukzn.ac.za |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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