HIV-related Malignancies

Question 1

Kaposi Sarcoma

Answer 1

Endothelial malignancy usu of skin, also mouth, GI tract, respiratory tract.
Assoc. w HHV-8 and HIV.
KSHV - Kaposi sarcoma herpes virus.
Latent and lytic infections.
Mistaken for bacillary angiomatosis, but has lymphocytic infiltrate.
Does not integrate - remains episomal.
Purple patches, plaques, nodules.
AIDS - tumor spreads early and tx is ART.

Question 2

Primary CNS Lymphoma

Answer 2

Adults.
Assoc w HIV/AIDS.
AIDS-defining illness.
Variable presentation: confusion, memory loss, seizures.
Mass lesion on MRI.
Distinguish from toxoplasmosis via CSF analysis/lab testing.
Most common type is diffuse large B cell, immunoblastic.
Occurs in setting of severe immune suppression.
Always EBV+.

Question 3

Lymphocyte Depleted Hodgkin Lymphoma

Answer 3

Most aggressive HL type.

Usu in elderly or HIV+.

Question 4

Primary Effusion Lymphoma

Answer 4

Caused by KSHV and often coexists w Kaposi Sarcoma.
Rare.
Usu young, MSM w advanced HIV.
Disease usu restricted to pericardium, pleura, peritoneal cavity w/o contiguous tumor mass.
Tumor is B cell lineage.

Question 5

SCC of Cervix

Answer 5

AIDS-defining illness.
HPV-16 and 18.
Suppressed immunity –> persistent HPV infection –> more likely virus to be integrated –> carcinoma.