1
|
Anjomshoaa I, Bulford LA, Dym H, Woo SB. Florid follicular lymphoid hyperplasia of the hard palatal mucosa managed with intralesional steroids: a case report and review of the literature. J Oral Maxillofac Surg 2013; 71:1202-8. [PMID: 23522767 DOI: 10.1016/j.joms.2013.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 01/13/2023]
Abstract
Follicular lymphoid hyperplasia of the palate is a benign lymphoproliferative lesion of unknown pathogenesis. It presents usually in female patients as a painless, firm, well-demarcated, usually nonulcerated, slow-growing lesion on the palate that histopathologically may resemble a lymphoma. The authors describe a patient with this condition that was successfully treated with intralesional steroid injections. Previously reported cases were reviewed to assess the results of various treatment modalities and disease-free outcome. A nonsurgical approach to the management of follicular lymphoid hyperplasia may have better patient acceptance and satisfaction without recurrence.
Collapse
Affiliation(s)
- Ida Anjomshoaa
- Division of Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, Brooklyn, NY 11201, USA.
| | | | | | | |
Collapse
|
2
|
Levay PF, Botes ME. Diffuse Infiltrative Lymphocytosis Syndrome (DILS). S Afr Fam Pract (2004) 2008. [DOI: 10.1080/20786204.2008.10873692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
3
|
Tomashefski JF, Cagle PT, Farver CF, Fraire AE. Collagen Vascular Diseases and Disorders of Connective Tissue. DAIL AND HAMMAR’S PULMONARY PATHOLOGY 2008. [PMCID: PMC7120184 DOI: 10.1007/978-0-387-68792-6_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The collagen vascular diseases, also referred to as connective tissue diseases, are a diverse group of systemic inflammatory disorders thought to be immunologically mediated. The concept of collagen vascular disease began to take shape in the 1930s, when it was recognized that rheumatic fever and rheumatoid arthritis can affect connective tissues throughout the body.1,2 During the following decade, as conditions such as systemic lupus erythematosus (SLE) and scleroderma came to be viewed as systemic diseases of connective tissue, the terms diffuse connective disease and diffuse collagen disease were proposed.3,4 During the same period, the designation of diffuse vascular disease was proposed for diseases such as scleroderma, polymyositis, SLE, and polyarteritis nodosa, which featured widespread vascular involvement.5 With the realization that many of these entities can exhibit both systemic connective tissue manifestations and vascular abnormalities, the unifying designation of collagen vascular disease was introduced.6
Collapse
Affiliation(s)
- Joseph F. Tomashefski
- grid.67105.350000000121643847Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH USA ,grid.411931.f0000000100354528Department of Pathology, MetroHealth Medical Center, Cleveland, OH USA
| | - Philip T. Cagle
- grid.5386.8000000041936877XDepartment of Pathology, Weill Medical College of Cornell University, New York, NY ,grid.63368.380000000404450041Pulmonary Pathology, Department of Pathology, The Methodist Hospital, Houston, TX USA
| | - Carol F. Farver
- grid.239578.20000000106754725Pulmonary Pathology, Department of Anatomic Pathology, The Cleveland Clinic Foundation, Cleveland, OH USA
| | - Armando E. Fraire
- grid.168645.80000000107420364Department of Pathology, University of Massachusetts Medical School, Worcester, MA USA
| |
Collapse
|
4
|
Zafrani L, Coppo P, Dettwiler S, Molinier-Frenkel V, Agbalika F, Guiard-Schmid JB, Pialoux G, Xu-Dubois YC, Rondeau E, Hertig A. Nephropathy associated with the diffuse infiltrative lymphocytosis syndrome. Kidney Int 2007; 72:219-24. [PMID: 17361111 DOI: 10.1038/sj.ki.5002207] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- L Zafrani
- APHP, Hopital Tenon, Urgences Néphrologiques & Transplantation Rénale, et Université Pierre et Marie Curie (UPMC), Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Medina F, Pérez-Saleme L, Moreno J. Rheumatic manifestations of human immunodeficiency virus infection. Infect Dis Clin North Am 2007; 20:891-912. [PMID: 17118295 DOI: 10.1016/j.idc.2006.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Rheumatic complaints are common in patients with HIV, and HIV positivity confers an increased susceptibility in populations with similar risk factors for HIV infection. With the advent of the modern combined antiretroviral treatment, HAART has had a profound beneficial effect on survival in HIV-infected patients, with lifelong control of HIV infection and normalization of life expectancy; but it has also contributed to both an altered frequency and a different nature of rheumatic complications now being observed in this population, with new rheumatic complications, such as osteoporosis, osteonecrosis, gout, mycobacterial, mycotic osteoarticular infections, and neoplasia perhaps more prevalent. Rheumatologists, internists, and general physicians need to be aware of these changes to provide optimal diagnosis and how to disclose the results to their patients. They also need to be familiar with the management of HIV infection and to direct careful attention to the prevention of HIV transmission in health care facilities.
Collapse
Affiliation(s)
- Francisco Medina
- Rheumatology Department, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, 330 Cuauhtemoc Avenue, México City, DF 06720, Mexico.
| | | | | |
Collapse
|
6
|
Abstract
Lymphoid lesions of the lung produce a complex of problems for the practicing pathologist. Although these lesions are eventually referred to hematopathologists, it is still the general surgical pathologist who first encounters them and confronts the problem of formulating an initial diagnosis. Over the last 20 years there has been a revolution in our knowledge of the classification and natural history of the pulmonary lesions, a plethora of information which warrants a thorough review. The purpose of this discussion is to report the clinical features and courses, pathologic features and, when known, etiologies or pathogenesis of the major "primary" pulmonary lymphoid lesions and present a brief approach to differential diagnosis. I will divide the lesions into malignant and benign, discussing each in turn.
Collapse
Affiliation(s)
- Michael N Koss
- Department of Pathology, Keck School of Medicine, University of Southern California, Hoffman Medical Research Building Room 209, 2011 Zonal Avenue, Los Angeles, CA 90033, USA
| |
Collapse
|
7
|
Medina Rodríguez F. Rheumatic manifestations of human immunodeficiency virus infection. Rheum Dis Clin North Am 2003; 29:145-61, viii. [PMID: 12635505 DOI: 10.1016/s0889-857x(02)00099-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Rheumatic complaints are common in patients with human immunodeficiency virus (HIV) infection. With the advent of the modern combined antiretroviral treatment, life-long control of HIV infection and normalization of life expectancy in HIV-positive patients have become realistic perspectives, but new rheumatic complications, such as osteoporosis, osteonecrosis, gout, and mycobacterial and mycotic osteoarticular infections may be more prevalent. Rheumatologists, internists, and general physicians need to be familiar with the presentation and treatment of these conditions in HIV-positive patients.
Collapse
Affiliation(s)
- Francisco Medina Rodríguez
- Department of Rheumatology, Hospital de Especialidades Centro Médico Nacional, Siglo XXI Instituto Mexicano del Seguro Social, Universidad Nacional Autónoma de México, Facultad de Medicina, México City, Mexico.
| |
Collapse
|
8
|
Williams DW, Leigh J, Ramirez-Amador V, Kaonga K, Russo D, Schiødt M. Host pathogen interaction and the development of oral lesions. Oral Dis 2002; 8 Suppl 2:120-5. [PMID: 12164645 DOI: 10.1034/j.1601-0825.8.s2.2.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aetiologies of oral ulceration, disseminated interstitial lymphocytosis syndrome and oral lymphomas have been reviewed, with emphasis on the role of HIV infection in the primary causation or modification of the presentation of these entities. There is a paucity of evidence to explain why oral ulceration is so severe in HIV infection, and why major ulceration affects the oropharynx. A number of mechanisms have been proposed to account for the development of lymphomas in patients with HIV infection, including a genetic predisposition, decreased immunosurveillance due to HIV infection, alteration of endothelial cell function and dysregulation of cytokine networks. From this review, it was concluded that there is a need for a prospective multicentre study, to elucidate the aetiological mechanisms involved in lymphomas of the oral regions in this patient group. It was concluded that, although there is anecdotal evidence implicating tobacco use in the aetiology of the lesions reviewed, this is insufficient to allow definitive statements to be made and further systematic evaluation is indicated.
Collapse
Affiliation(s)
- David W Williams
- Barts and The London, Queen Mary's School of Medicine and Dentistry, UK.
| | | | | | | | | | | |
Collapse
|
9
|
McArthur CP, Subtil-DeOliveira A, Palmer D, Fiorella RM, Gustafson S, Tira D, Miranda RN. Characteristics of salivary diffuse infiltrative lymphocytosis syndrome in West Africa. Arch Pathol Lab Med 2000; 124:1773-9. [PMID: 11100056 DOI: 10.5858/2000-124-1773-cosdil] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the prevalence of diffuse infiltrative lymphocytosis syndrome (DILS) in the minor salivary glands of 30 African Cameroonian adults with the acquired immunodeficiency syndrome (AIDS). DESIGN Salivary gland tissue was analyzed using a modified classification system that was developed to aid the diagnosis of Sjögren syndrome. The advantages and disadvantages of this approach are discussed. MATERIALS AND METHODS Formalin-fixed, paraffin-embedded, hematoxylin-eosin-stained biopsy sections were prepared for 30 patients with AIDS, 26 healthy individuals who declined human immunodeficiency virus (HIV) testing, and 4 seronegative healthy controls. Tissues were immunostained for CD4/CD8+ lymphocytes and cytomegalovirus (CMV), and transmission electron microscopy was performed to locate viral particles. Patients were tested for HIV-1 and HIV-2 by the HIV/Chek System 3 or CAMSTIX-HIV-1 and HIV-2 assay. RESULTS Severe salivary ductal atypia (96%) was the feature most strongly associated with AIDS, and the lymphocytic focus score was the second histologic feature most strongly correlated with AIDS. Forty-eight percent of patients with HIV-1 infection had more than 1 lymphocytic focus in a minor salivary gland. These lymphocytes were primarily CD8+. We report, to the best of our knowledge, the first case of multinucleated salivary duct epithelial cells in minor salivary glands also containing enveloped virus particles. All cases were negative for CMV. CONCLUSIONS The prevalence of DILS in West Africans with AIDS appears higher than the prevalence reported in whites from the United States and Europe and in blacks from the United States, a group that has been reported to have a greater incidence of DILS than whites. This discrepancy may be related to differences in patient selection criteria. The determination of lymphocytic focus score, as used in the diagnosis of Sjögren syndrome, with the adjunct of ductal atypia is useful for assessing DILS. The impact of patient selection, drug therapy, and parasites on salivary gland pathology is discussed.
Collapse
Affiliation(s)
- C P McArthur
- Department of Pathology, Truman Medical Center, Kansas City, MO 64108, USA.
| | | | | | | | | | | | | |
Collapse
|
10
|
Reveille JD. The changing spectrum of rheumatic disease in human immunodeficiency virus infection. Semin Arthritis Rheum 2000; 30:147-66. [PMID: 11124280 DOI: 10.1053/sarh.2000.16527] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
CONTEXT Although it has been known for over 15 years that a number of rheumatic diseases occur in patients with human immunodeficiency virus (HIV) infection, increasing knowledge about these disorders and advances in HIV treatment need to be considered in approaching patients with HIV-associated rheumatic disease. OBJECTIVE To examine the clinical, pathologic, and therapeutic features of HIV-associated rheumatic diseases in the context of what is known about the immunology of HIV infection. DATA SOURCES The author's own extensive collection of references, supplemented by PubMed Medline searches for articles in English-language journals published between 1985 and 2000. The indexing term HIV and the following coindexing terms were used for searching: arthritis, Reiter's syndrome, psoriatic arthritis, rheumatoid arthritis, osteonecrosis, vasculitis, pulmonary hypertension, myositis, myopathy, fibromyalgia, septic arthritis, parotid enlargement, diffuse infiltrative lymphocytosis syndrome, systemic lupus erythematosus, septic arthritis, mycobacterial arthritis, fungal arthritis, autoantibodies, anti-cardiolipin antibodies, and anti-neutrophilic cytoplasmic antibodies. STUDY SELECTION All papers identified in the literature search were reviewed. Studies presenting data that merely confirmed previous studies were not included in the analysis. DATA EXTRACTION All identified papers were abstracted by the author. Letters to the editor were included only if a new observation had been made. DATA SYNTHESIS This was a qualitative review of papers published, with new knowledge about these disorders summarized and presented. RESULTS Despite new treatments for HIV, reports of rheumatic diseases presenting in AIDS patients persist, especially in HIV-associated arthritis, diffuse infiltrative lymphocytosis syndrome, HIV-associated vasculitis, and polymyositis. However, new HIV treatments may ameliorate these diseases. CONCLUSIONS The spectrum of HIV-associated rheumatic disease remains a diagnostic and therapeutic challenge for the clinician. The impact of changes in HIV treatment on these disorders requires further assessment.
Collapse
Affiliation(s)
- J D Reveille
- Department of Medicine (Division of Rheumatology and Clinical Immunogenetics), The University of Texas-Houston Health Science Center (UTH-HSC), Houston, TX 77030, USA.
| |
Collapse
|
11
|
Manuel Sancho J, Vaquero M, Sirerac G, Maria Ribera J. Síndrome de linfocitosis CD8 infiltrativo difuso en un paciente con infección por el virus de la inmunodeficiencia humana. Med Clin (Barc) 2000. [DOI: 10.1016/s0025-7753(00)71572-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Abstract
The exact incidence of malignancies in HIV-infected children is not clear; however, an excess of non-Hodgkin's lymphomas (NHLs) and soft tissue tumors (leiomyosarcomas) is evident. The spectrum of diseases is slightly different in children compared to adults. For example, Kaposi's sarcoma (KS), although common in HIV-infected adults, is rare in children in industrialized countries. Preliminary results with brief, dose-intensive chemotherapeutic regimens have been encouraging. Such regimens may be complicated, however, by multiple HIV-associated organ dysfunctions, drug interactions, and infectious complications secondary to severe immunosuppression.
Collapse
Affiliation(s)
- B U Mueller
- Department of Pediatrics, Harvard Medical School, Children's Hospital, Boston, Massachusetts, USA.
| |
Collapse
|
13
|
|
14
|
Moulignier A, Authier FJ, Baudrimont M, Pialoux G, Belec L, Polivka M, Clair B, Gray F, Mikol J, Gherardi RK. Peripheral neuropathy in human immunodeficiency virus-infected patients with the diffuse infiltrative lymphocytosis syndrome. Ann Neurol 1997; 41:438-45. [PMID: 9124800 DOI: 10.1002/ana.410410406] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A subset of human immunodeficiency virus (HIV)-infected patients develop persistent CD8 hyperlymphocytosis and a Sjogren's syndrome-like syndrome associated with multivisceral CD8 T-cell infiltration, known as the diffuse infiltrative lymphocytosis syndrome (DILS). Patients with DILS tend to have higher CD4 cell counts, fewer opportunistic infections, and longer survival times than other HIV-infected patients. Peripheral nerve involvement in DILS has been poorly documented. We studied 12 HIV-infected patients with CD8 hyperlymphocytosis, DILS, and clinical signs of peripheral neuropathy. Two of 4 patients who were HLA typed were HLA-DR5 and 1 was HLA-DR6. All patients had the sicca syndrome and multivisceral involvement. The neuropathy was acute or subacute, always painful, and symmetrical in 8 cases. Electrophysiology was consistent with axonal neuropathy in 10 of 12 patients. Nerve biopsy showed marked angiocentric CD8 infiltrates without mural necrosis (12 of 12), and abundant expression of HIV p24 protein in macrophages (12 of 12). The HIV genome was detected by polymerase chain reaction in nerve homogenates. Zidovudine therapy was associated with improvement in 6 of 6 patients and steroid therapy was beneficial in 4 of 5 patients. No T-cell lymphoma was observed during follow-up, but 2 patients developed a primary B-cell lymphoma. We conclude that DILS neuropathy represents HIV-associated neuropathy, characterized by marked CD8 infiltration and abundant HIV in nerve, that improves with zidovudine or steroid therapy, and probably reflects a systemic host-determined and antigen-driven response to HIV.
Collapse
Affiliation(s)
- A Moulignier
- Service de Neurologie, Fondation Adolphe de Rothschild, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Solomon KS, Levin TL, Berdon WE, Romney B, Ruzal-Shapiro C, Bye MR. Pneumothorax as the presenting sign of Pneumocystis carinii infection in an HIV-positive child with prior lymphocytic interstitial pneumonitis. Pediatr Radiol 1996; 26:559-62. [PMID: 8753672 DOI: 10.1007/bf01372242] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An HIV-positive child presented with a pneumothorax secondary to cavitary Pneumocystis carinii pneumonia (PCP). Lymphocytic interstitial pneumonitis had been evident on earlier radiographs but had resolved, concurrent with a decrease in her CD4 counts, before the radiographic changes of PCP became evident. As immune function declines in HIV-positive children, the chest radiograph may paradoxically clear. In such a setting, development of focal lung disease, including pneumothorax, may herald Pneumocystis carinii infection.
Collapse
Affiliation(s)
- K S Solomon
- Department of Radiology, Division of Pediatric Radiology, Babies & Children's Hospital of New York, Columbia-Presbyterian Medical Center, 3959 Broadway, BHN 3-318, New York, NY 10032, USA
| | | | | | | | | | | |
Collapse
|
16
|
Ugen KE, Wang B, Ayyavoo V, Agadjanyan M, Boyer J, Li F, Kudchodkar S, Lin J, Merva M, Fernandes L. DNA inoculation as a novel vaccination method against human retroviruses with rheumatic disease associations. Immunol Res 1994; 13:154-62. [PMID: 7775806 DOI: 10.1007/bf02918276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
There are a number of rheumatologic manifestations of human retroviral infections associated with human immunodeficiency virus type I (HIV-I) and the human T-cell leukemia virus type I (HTLV-I) including arthritis, Sjøgren's syndrome-like symptoms as well as other varied autoimmune phenomena. Infection with HTLV-1 may be directly involved in the etiology and/or pathogenesis of an arthritic condition similar to rheumatoid arthritis. We have been characterizing a new vaccination strategy against human retroviral infections, designated DNA inoculation. This procedure involves the intramuscular injection of DNA plasmids which express specific human retroviral antigens. This technique results in the development of humoral and cellular immune responses against these proteins. Specifically, this method has been successfully used to develop immune responses against HIV-I and HTLV-I. The availability of rat and rabbit infection models for HTLV-I, coupled with the successful development of immune responses in these animals after DNA inoculation with an HTLV-I envelope expressing plasmid, will allow the efficacy of this vaccination technique to be evaluated with protection against in vivo viral challenge as an endpoint.
Collapse
Affiliation(s)
- K E Ugen
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|