Bradshaw Stanley, Oertling Estelle, Rezigh Austin
University of Texas Southwestern Medical Center, Dallas, Texas, USA.
University of Texas Southwestern Medical Center, Dallas, Texas, USA
BMJ Case Rep. 2022 Mar 29;15(3):e245306. doi: 10.1136/bcr-2021-245306.
While infection should always lead the differential when a patient with AIDS presents with fever, inflammatory and malignant aetiologies should also be considered. With profound immunocompromise, malignancies can develop as sequelae of viral oncogene expression. Human herpesvirus 8 (HHV-8) infection drives several AIDS-related cancers including Kaposi sarcoma (KS), multicentric Castleman disease and primary effusion lymphoma (PEL), which can present simultaneously with variable clinical features. Herein, we describe a case of synchronous visceral KS and extracavitary PEL in a patient with AIDS. The patient was treated with systemic chemotherapy and remains in remission after four cycles. We review other cases of copresenting HHV-8-related malignancies, explore the salient pathomechanisms and clinical features of these cancers and discuss treatment strategies.
当艾滋病患者出现发热时,虽然感染始终是鉴别诊断的首要考虑因素,但也应考虑炎症和恶性病因。由于严重免疫功能低下,恶性肿瘤可作为病毒癌基因表达的后遗症而发生。人类疱疹病毒8型(HHV-8)感染可引发多种与艾滋病相关的癌症,包括卡波西肉瘤(KS)、多中心Castleman病和原发性渗出性淋巴瘤(PEL),这些癌症可同时出现不同的临床特征。在此,我们描述了一例艾滋病患者同时发生内脏KS和腔外PEL的病例。该患者接受了全身化疗,四个周期后仍处于缓解期。我们回顾了其他同时出现HHV-8相关恶性肿瘤的病例,探讨了这些癌症的主要发病机制和临床特征,并讨论了治疗策略。