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Abstract
Epstein-Barr Virus-Associated Smooth-Muscle Tumor in Acquired Immunodeficiency Syndrome
Suankratay C.1, Shuangshoti S.2, Mutirangura A.3, Wilde H.4
Introduction: Apart from an increased risk of developing tumors such as lymphoma, cervical cancer and Kaposi´s sarcoma, several reports have documented a rising incidence of smooth-muscle tumors (SMTs) in acquired immunodeficiency virus (AIDS) patients.The literature suggests the association between Epstein-Barr virus (EBV) and these rare tumors in patients with AIDS or following transplantation.In contrast to previous reports which described unifocal SMTs in non-HIV patients that mostly involved the genitourinary or gastrointestinal tract, we observed unusual lesions that were multifocal in nature and involved the central nervous system of AIDS patients.
Methods: All patients with AIDS and SMT were included in our study at Chulalongkorn Hospital between 2001 and 2003. Each patient was followed for at least 6 months after enrollment. All specimens were confirmed for SMT and EBV by immunohistochemistry and in situ hybridization. Samples of plasma and serum were tested for EBV by real-time quantitative PCR and EBV serology.
Results: There were 8 adults and one child (3 males and 6 females). The mean age was 33.3 years (range: 4-49 years). At the end of the study, 3 patients died and 6 patients survived. The sites of SMTs were: epidura (5 intracranial and 4 intraspinal), vocal cords (2), adrenal glands (2), abdominal wall (2), iris (1), liver (1), lung (1), orbit (1) and thigh (1). 7 patients had multicentric tumors involving intracranial (4), extra- and intracranial (3), or extracranial sites (2).All 5 patients with intracranial tumors presented as single or multiple extraaxial dural-based masses located in the sellar region. Intraspinal tumors presented as single or multiple dumbbell-shaped extradural masses. We found evidence of EBV infection in all SMTs. Plasma EBV DNA was detectable in 2 patients.
Conclusions: SMTs in AIDS patients typically arise in multiple and very unusual sites which are not observed in immunocompetent individuals. Our series also suggests association between EBV and the SMT.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe1.4C01
Suggested Citation
"SuankratayC., et al.
Epstein-Barr Virus-Associated Smooth-Muscle Tumor in Acquired Immunodeficiency Syndrome.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe1.4C01"
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