Gastrointestinal malignancies in HIV-infected or immunosuppressed patients: Pathologic features and review of the literature

Advances in Anatomic Pathology

Volumn 14, Issue 6, 2007, Pages 431-443

  Ho Yen, Colan ^a   Chang, Fuju ^a   Van Der Walt, Jon ^a   Lucas, Sebastian ^a  

^a ST THOMAS HOSPITAL   (United Kingdom)

Author keywords

AIDS associated malignancy; AIDS associated non Hodgkin lymphoma; Anal intraepithelial neoplasia; Anal squamous cell carcinoma; Gastrointestinal tract; Histopathology; Kaposi sarcoma; Posttransplant lymphoproliferative disorder

Indexed keywords

ACQUIRED IMMUNE DEFICIENCY SYNDROME; CANCER RISK; CLINICAL FEATURE; DIFFERENTIAL DIAGNOSIS; DIGESTIVE SYSTEM CANCER; DISEASE ASSOCIATION; EPSTEIN BARR VIRUS; HISTOPATHOLOGY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENT; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; IMMUNE DEFICIENCY; IMMUNOHISTOCHEMISTRY; KAPOSI SARCOMA; LYMPHOMA; LYMPHOPROLIFERATIVE DISEASE; MUSCLE TUMOR; NONHODGKIN LYMPHOMA; PRIORITY JOURNAL; PROGNOSIS; REVIEW; SQUAMOUS CELL CARCINOMA;

ACQUIRED IMMUNODEFICIENCY SYNDROME; GASTROINTESTINAL NEOPLASMS; HUMANS; IMMUNOCOMPROMISED HOST; IMMUNOSUPPRESSION; LYMPHOMA, AIDS-RELATED; SARCOMA, KAPOSI;

EID: 37349131876     PISSN: 10724109     EISSN: 15334031     Source Type: Journal    
DOI: 10.1097/PAP.0b013e31815946d9     Document Type: Review

References (103)

1. Yarchoan R, Tosato G, Little RF. Therapy insight: AIDS-related malignancies - the influence of antiviral therapy on pathogenesis and management. Nat Clin Pract Oncol. 2005;2:406-415.
2. Rotterdam H, Tsang P. Gastrointestinal disease in the immunocompromised patient. Human Pathol. 1994;25:1123-1140.
3. Younes BS, Ament ME, McDiarmid SV, et al. The involvement of the gastrointestinal tract in posttransplant lymphoproliferative disease in pediatric liver transplantation. J Pediatr Gastroenterol Nutr. 1999;28:380-385.
4. Cheuk W, Li PC, Chan JK. Epstein-Barr virus-associated smooth muscle tumour: a distinctive mesenchymal tumour of immunocompromised individuals. Pathology. 2002;34:245-249.
5. Clark MA, Hartley A, Geh JI. Cancer of the anal canal. Lancet Oncol. 2004;5:149-157.
6. Palefsky JM, Holly EA, Hogeboom CJ, et al. Virologic, immunologic, and clinical parameters in the incidence and progression of anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual men. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17:314-319.
7. Hengge UR, Ruzicka T, Tyring SK, et al. Update on Kaposi's sarcoma and other HHV8 associated diseases. Part 1: Epidemiology, environmental predispositions, clinical manifestations, and therapy. Lancet Infect Dis. 2002;2:281-292.
8. Barrison IG, Foster S, Harris JW, et al. Upper gastrointestinal Kaposi's sarcoma in patients positive for HIV antibody without cutaneous disease. Br Med J (Clin Res Ed). 1988;296:92-93.
9. Sakagami J, Sogame Y, Kataoka K, et al. Endoscopic resection for the diagnosis of visceral Kaposi's sarcoma. J Gastroenterol. 2005; 40:98-103.
10. Wang NC, Chang FY, Chou YY, et al. Intussusception as the initial manifestation of AIDS associated with primary Kaposi's sarcoma: a case report. J Formos Med Assoc. 2002;101:585-587.
11. Neville CR, Peddada AV, Smith D, et al. Massive gastrointestinal hemorrhage from AIDS-related Kaposi's sarcoma confined to small bowel managed with radiation. Med Pediatr Oncol. 1996; 26:135-138.
12. Lin CH, Hsu CW, Chiang YJ, et al. Esophageal and gastric Kaposi's sarcomas presenting as upper gastrointestinal bleeding. Chang Gung Med J. 2002;25:329-333.
13. Weprin L, Zollinger R, Clausen K, et al. Kaposi's sarcoma: endoscopic observations of gastric and colon involvement. J Clin Gastroenterol. 1982;4:357-360.
14. Chor PJ, Santa Cruz DJ. Kaposi's sarcoma. A clinicopathologic review and differential diagnosis. J Cutan Pathol. 1992;19:6-20.
15. Huang WY, Pantanowitz L, Dezube BJ. Unusual sites of malignancies: case 3. AIDS-related Kaposi's sarcoma of the gastrointestinal tract. J Clin Oncol. 2005;23:2098-2099.
16. Russell Jones R, Orchard G, Zelger B, et al. Immunostaining for CD31 and CD34 in Kaposi sarcoma. J Clin Pathol. 1995;48: 1011-1016.
17. Miettinen M, Lindenmayer AE, Chaubal A. Endothelial cell markers CD31, CD34, and BNH9 antibody to H- and Y-antigens - evaluation of their specificity and sensitivity in the diagnosis of vascular tumors and comparison with von Willebrand factor. Mod Pathol. 1994;7:82-90.
18. Facchetti F, Lucini L, Gavazzoni R, et al. Immunomorphological analysis of the role of blood vessel endothelium in the morphogenesis of cutaneous Kaposi's sarcoma: a study of 57 cases. Histopathology. 1988;12:581-593.
19. Kahn HJ, Bailey D, Marks A. Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas. Mod Pathol. 2002;15: 434-440.
20. Patel RM, Goldblum JR, Hsi ED. Immunohistochemical detection of human herpes virus-8 latent nuclear antigen-1 is useful in the diagnosis of Kaposi sarcoma. Mod Pathol. 2004;17:456-460.
21. Chetty R, Sabaratnam RM. Upper gastrointestinal bacillary angiomatosis causing hematemesis: a case report. Int J Surg Pathol. 2003;11:241-244.
22. Walford N, Van der Wouw PA, Das PK, et al. Epithelioid angiomatosis in the acquired immunodeficiency syndrome: morphology and differential diagnosis. Histopathology. 1990;16: 83-88.
23. Yao T, Nagai E, Utsunomiya T, et al. An intestinal counterpart of pyogenic granuloma of the skin. A newly proposed entity. Am J Surg Pathol. 1995;19:1054-1060.
24. van Eeden S, Offerhaus GJ, Morsink FH, et al. Pyogenic granuloma: an unrecognized cause of gastrointestinal bleeding. Virchows Arch. 2004;444:590-593.
25. Carmen Gonzalez-Vela M, Fernando Val-Bernal J, Francisca Garijo M, et al. Pyogenic granuloma of the sigmoid colon. Ann Diagn Pathol. 2005;9:106-109.
26. Allison KH, Yoder BJ, Bronner MP, et al. Angiosarcoma involving the gastrointestinal tract: a series of primary and metastatic cases. Am J Surg Pathol. 2004;28:298-307.
27. Brown CJ, Falck VG, MacLean A. Angiosarcoma of the colon and rectum: report of a case and review of the literature. Dis Colon Rectum. 2004;47:2202-2207.
28. Kelemen K, Yu QQ, Howard L. Small intestinal angiosarcoma leading to perforation and acute abdomen: a case report and review of the literature. Arch Pathol Lab Med. 2004;128:95-98.
29. Krause J. AIDS-related non-Hodgkin's lymphomas. Microsc Res Tech. 2005;68:168-175.
30. Jaffe JS, Harris NL, Stein H, et al. Pathology and genetics of tumours of the haematopoietic and lymphoid tissues. World Health Organisation Classification of Tumours. Lyon, France: IARC Press; 2001.
31. Knowles DM, Pirog EC. Pathology of AIDS-related lymphomas and other AIDS-defining neoplasms. Eur J Cancer. 2001;37: 1236-1250.
32. Danzig JB, Brandt LJ, Reinus JF, et al. Gastrointestinal malignancy in patients with AIDS. Am J Gastroenterol. 1991;86: 715-718.
33. Cappell MS, Botros N. Predominantly gastrointestinal symptoms and signs in 11 consecutive AIDS patients with gastrointestinal lymphoma: a multicenter, multiyear study including 763 HIV-seropositive patients. Am J Gastroenterol. 1994;89:545-549.
34. Beck PL, Gill MJ, Sutherland LR. HIV-associated non-Hodgkin's lymphoma of the gastrointestinal tract. Am J Gastroenterol. 1996; 91:2377-2381.
35. Heise W, Arasteh K, Mostertz P, et al. Malignant gastrointestinal lymphomas in patients with AIDS. Digestion. 1997;58:218-224.
36. Carbone A. AIDS-related non-Hodgkin's lymphomas: from pathology and molecular pathogenesis to treatment. Hum Pathol. 2002;33:392-404.
37. Knowles DM, Chamulak GA, Subar M, et al. Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS). The New York University Medical Center experience with 105 patients (1981-1986). Ann Intern Med. 1988;108: 744-753.
38. Ioachim HL, Antonescu C, Giancotti F, et al. EBV-associated anorectal lymphomas in patients with acquired immune deficiency syndrome. Am J Surg Pathol. 1997;21:997-1006.
39. Carbone A, Tirelli U, Vaccher E, et al. A clinicopathologic study of lymphoid neoplasias associated with human immunodeficiency virus infection in Italy. Cancer. 1991;68:842-852.
40. Carbone A, Gloghini A, Larocca LM, et al. Expression profile of MUM1/IRF4, BCL-6, and CD138/syndecan-1 defines novel histogenetic subsets of human immunodeficiency virus-related lymphomas. Blood. 2001;97:744-751.
41. Harris NL, Horning SJ. Burkitt's lymphoma - the message from micro-arrays. N Engl J Med. 2006;354:2495-2498.
42. Delecluse HJ, Anagnostopoulos I, Dallenbach F, et al. Plasmablastic lymphomas of the oral cavity: a new entity associated with the human immunodeficiency virus infection. Blood. 1997;89: 1413-1420.
43. Vega F, Chang C-C, Medeiros L, et al. Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles. Mod Pathol. 2005;18:806-815.
44. Huang Q, Chang K, Gaal K, et al. Primary effusion lymphoma with subsequent development of a small bowel mass in an HIV-seropositive patient. Am J Surg Pathol. 2002;26:1363-1367.
45. Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer. 1983;52:1410-1416.
46. Wotherspoon AC, Diss TC, Pan L, et al. Low grade gastric B-cell lymphoma of mucosa associated lymphoid tissue in immunocompromised patients. Histopathology. 1996;28:129-134.
47. Chetty R, Pillay SV. Coexistent gastric MALT lymphoma and Kaposi sarcoma in an HIV positive patient. J Clin Pathol. 1999;52: 313-316.
48. Larroche C, Cacoub P, Soulier J, et al. Castleman's disease and lymphoma: report of eight cases in HIV-negative patients and literature review. Am J Hematol. 2002;69:119-126.
49. Valmary S, Richard P, Brousset P. Frequent detection of Kaposi's sarcoma herpesvirus in germinal centre macrophages from AIDS-related multicentric Castleman's disease. AIDS. 2005;19: 1229-1231.
50. Kim KN, Lee KN, Kang MJ, et al. Hyaline vascular-type Castleman disease presenting as an esophageal submucosal tumor: case report. Korean J Radiol. 2006;7:73-76.
51. Goetze O, Banasch M, Junker K, et al. Unicentric Castleman's disease of the pancreas with massive central calcification. World J Gastroenterol. 2005;11:6725-6727.
52. Papaziogas B, Chatzimavroudis G, Koutelidakis I, et al. A rare form of isolated mesenteric Castleman's disease presenting as an abdominal mass (isolated mesenteric Castleman's disease). J Gastrointestin Liver Dis. 2006;15:171-174.
53. Kaluza G, Willems WR, Lohmeyer J, et al. A monoclonal antibody that recognises a formalin-resistant epitope on the p24 core protein of HIV-1. Path Res Pract. 1992;188:91-96.
54. Hessol NA, Katz MH, Liu JY, et al. Increased incidence of Hodgkin disease in homosexual men with HIV infection. Ann Intern Med. 1992;117:309-311.
55. Cheung TW, Arai S. HIV-associated Hodgkin's disease. AIDS Read. 1999;9:131-137.
56. Mori N, Yatabe Y, Narita M, et al. Primary gastric Hodgkin's disease. Morphologic, immunohistochemical, and immunogenetic analyses. Arch Pathol Lab Med. 1995;119:163-166.
57. Thompson LDR, Fisher SI, Chu WS, et al. HIV-associated Hodgkin lymphoma. A clinicopathologic and immunophenotypic study of 45 cases. Am J Clin Pathol. 2004;121:727-738.
58. Bower M. The management of lymphoma in the immunosuppressed patient. Best Pract Res Clin Haematol. 2002;15: 517-532.
59. Sebire NJ, Malone M, Risdon RA, et al. Epstein-Barr virus-associated lymphoproliferative disorder presenting as apparently isolated gastrointestinal lesions in childhood. Pediatr Dev Pathol. 2005;8:88-91.
60. Nalesnik MA, Jaffe R, Starzl TE, et al. The pathology of posttransplant lymphoproliferative disorders occurring in the setting of cyclosporine A-prednisone immunosuppression. Am J Pathol. 1988;133:173-192.
61. O'Connor JA, Cogley C, Burton M, et al. Posttransplantation lymphoproliferative disorder: endoscopic findings. J Pediatr Gastroenterol Nutr. 2000;31:458-461.
62. Semakula B, Rittenbach JV, Wang J. Hodgkin lymphoma-like posttransplantation lymphoproliferative disorder. Arch Pathol Lab Med. 2006;130:558-560.
63. Garnier JL, Lebranchu Y, Dantal J, et al. Hodgkin's disease after transplantation. Transplantation. 1996;61:71-76.
64. Pitman SD, Huang Q, Zuppan CW, et al. Hodgkin lymphoma-like posttransplant lymphoproliferative disorder (HL-like PTLD) simulates monomorphic B-cell PTLD both clinically and pathologically. Am J Surg Pathol. 2006;30:470-476.
65. Ryan DP, Mayer RJ. Anal carcinoma: histology, staging, epidemiology, treatment. Curr Opin Oncol. 2000;12:345-352.
66. Adami J, Gabel H, Lindelof B, et al. Cancer risk following organ transplantation: a nationwide cohort study in Sweden. Br J Cancer. 2003;89:1221-1227.
67. Scholefield JH, Sonnex C, Talbot IC, et al. Anal and cervical intraepithelial neoplasia: possible parallel. Lancet. 1989;2: 765-769.
68. Ogunbiyi OA, Scholefield JH, Raftery AT, et al. Prevalence of anal human papillomavirus infection and intraepithelial neoplasia in renal allograft recipients. Br J Surg. 1994;81:365-367.
69. Martin F, Bower M. Anal intraepithelial neoplasia in HIV positive people. Sex Transm Infect. 2001;77:327-331.
70. Zbar AP, Fenger C, Efron J, et al. The pathology and molecular biology of anal intraepithelial neoplasia: comparisons with cervical and vulvar intraepithelial carcinoma. Int J Colorectal Dis. 2002;17: 203-215.
71. Abbasakoor F, Boulos PB. Anal intraepithelial neoplasia. Br J Surg. 2005;92:277-290.
72. Cleary RK, Schaldenbrand JD, Fowler JJ, et al. Perianal Bowen's disease and anal intraepithelial neoplasia: review of the literature. Dis Colon Rectum. 1999;42:945-951.
73. Marchesa P, Fazio VW, Oliart S, et al. Perianal Bowen's disease: a clinicopathologic study of 47 patients. Dis Colon Rectum. 1997;40:1286-1293.
74. Skinner PP, Ogunbiyi OA, Scholefield JH, et al. Skin appendage involvement in anal intraepithelial neoplasia. Br J Surg. 1997;84: 675-678.
75. Mullerat J, Wong Te Fong LF, Davies SE, et al. Angiogenesis in anal warts, anal intraepithelial neoplasia and anal squamous cell carcinoma. Colorectal Dis. 2003;5:353-357.
76. Williams GR, Talbot IC. Anal carcinoma - a histological review. Histopathology. 1994;25:507-516.
77. Bogomoletz WV, Potet F, Molas G. Condylomata acuminata, giant condyloma acuminatum (Buschke-Loewenstein tumour) and verrucous squamous carcinoma of the perianal and anorectal region: a continuous precancerous spectrum? Histopathology. 1985; 9:155-169.
78. Chadwick EG, Connor EJ, Hanson IC, et al. Tumors of smooth-muscle origin in HIV-infected children. JAMA. 1990;263:3182-3184.
79. McClain KL, Leach CT, Jenson HB, et al. Association of Epstein-Barr virus with leiomyosarcomas in children with AIDS. N Engl J Med. 1995;332:12-18.
80. Lee ES, Locker J, Nalesnik M, et al. The association of Epstein-Barr virus with smooth-muscle tumors occurring after organ transplantation. N Engl J Med. 1995;332:19-25.
81. Lam KY. Oesophageal mesenchymal tumours: clinicopathological features and absence of Epstein-Barr virus. J Clin Pathol. 1999;52: 758-760.
82. Molle ZL, Bornemann P, Desai N, et al. Endoscopic features of intestinal smooth muscle tumor in a child with AIDS. Dig Dis Sci. 1999;44:910-915.
83. Deyrup AT, Lee VK, Hill CE, et al. Epstein-Barr virus-associated smooth muscle tumors are distinctive mesenchymal tumors reflecting multiple infection events: a clinicopathologic and molecular analysis of 29 tumors from 19 patients. Am J Surg Pathol. 2006;30:75-82.
84. Boman F, Gultekin H, Dickman PS. Latent Epstein-Barr virus infection demonstrated in low-grade leiomyosarcomas of adults with acquired immunodeficiency syndrome, but not in adjacent Kaposi's lesion or smooth muscle tumors in immunocompetent patients. Arch Pathol Lab Med. 1997;121:834-838.
85. Rogatsch H, Bonatti H, Menet A, et al. Epstein-Barr virus-associated multicentric leiomyosarcoma in an adult patient after heart transplantation: case report and review of the literature. Am J Surg Pathol. 2000;24:614-621.
86. Shinomura Y, Kinoshita K, Tsutsui S, et al. Pathophysiology, diagnosis, and treatment of gastrointestinal stromal tumors. J Gastroenterol. 2005;40:775-780.
87. Miettinen M, Sobin LH. Gastrointestinal stromal tumors in the appendix: a clinicopathologic and immunohistochemical study of four cases. Am J Surg Pathol. 2001;25:1433-1437.
88. Graadt van Roggen JF, van Velthuysen ML, Hogendoorn PC. The histopathological differential diagnosis of gastrointestinal stromal tumours. J Clin Pathol. 2001;54:96-102.
89. Gupta S, Punia RS, Kaushik R. Gastrointestinal stromal tumour of the colon presenting with intestinal obstruction. Indian J Cancer. 2004;41:175-177.
90. Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813-3825.
91. Wardelmann E, Neidt I, Bierhoff E, et al. c-kit mutations in gastrointestinal stromal tumors occur preferentially in the spindle rather than in the epithelioid cell variant. Mod Pathol. 2002;15: 125-136.
92. Rudolph P, Gloeckner K, Parwaresch R, et al. Immunophenotype, proliferation, DNA ploidy, and biological behavior of gastrointestinal stromal tumors: a multivariate clinicopathologic study. Hum Pathol. 1998;29:791-800.
93. Coffin CM, Watterson J, Priest JR, et al. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol. 1995;19:859-872.
94. Aboulafia DM. Inflammatory pseudotumor causing small bowel obstruction and mimicking lymphoma in a patient with AIDS: clinical improvement after initiation of thalidomide treatment. Clin Infect Dis. 2000;30:826-831.
95. Narla LD, Newman B, Spottswood SS, et al. Inflammatory pseudotumor. Radiographics. 2003;23:719-729.
96. Cheuk W, Woo PC, Yuen KY, et al. Intestinal inflammatory pseudotumour with regional lymph node involvement: identification of a new bacterium as the aetiological agent. J Pathol. 2000; 192:289-292.
97. Logani S, Lucas DR, Cheng JD, et al. Spindle cell tumors associated with mycobacteria in lymph nodes of HIV-positive patients: "Kaposi sarcoma with mycobacteria" and "mycobacterial pseudotumor." Am J Surg Pathol. 1999;23:656-661.
98. Umlas J, Federman M, Crawford C, et al. Spindle cell pseudotumor due to Mycobacterium avium-intracellulare in patients with acquired immunodeficiency syndrome (AIDS). Positive staining of mycobacteria for cytoskeleton filaments. Am J Surg Pathol. 1991; 15:1181-1187.
99. Chang KC, Jin YT, Chen FF, et al. Follicular dendritic cell sarcoma of the colon mimicking stromal tumour. Histopathology. 2001;38:25-29.
100. Cheuk W, Chan JK, Shek TW, et al. Inflammatory pseudotumor-like follicular dendritic cell tumor: a distinctive low-grade malignant intra-abdominal neoplasm with consistent Epstein-Barr virus association. Am J Surg Pathol. 2001;25:721-731.
101. Shek TW, Ho FC, Ng IO, et al. Follicular dendritic cell tumor of the liver. Evidence for an Epstein-Barr virus-related clonal proliferation of follicular dendritic cells. Am J Surg Pathol. 1996; 20:313-324.
102. Han JH, Kim SH, Noh SH, et al. Follicular dendritic cell sarcoma presenting as a submucosal tumor of the stomach. Arch Pathol Lab Med. 2000;124:1693-1696.
103. Perez-Ordonez B, Erlandson RA, Rosai J. Follicular dendritic cell tumor: report of 13 additional cases of a distinctive entity. Am J Surg Pathol. 1996;20:944-955.