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49 Cards in this Set
- Front
- Back
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What is the most common neoplasia in HIV? What is the relative risk?
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Kaposi's sarcoma. 73,000
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What are the four categories of Kaposi's sarcoma?
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1) AIDS related (MSM) 2) Iatrogenic (immune suppression 3) Endemic (Africa) 4) Classic (indolent, elderly men of Jewish/Mediterranean descent)
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What is the origin of Kaposi's sarcoma?
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Endothelial
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What virus is Kaposi's sarcoma associated with? Where is this virus latent?
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Kaposi's sarcoma herpes virus, latent in B lymphocytes
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How is KSHV detected? It is detected in ___% of KS.
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PCR, 100%
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Most patients with KS have antibodies against?
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KSHV
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KS occurs in __% of HIV+ individuals
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10-12%
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What is an important co-factor in KSHV induction of KS?
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HIV infection
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Has incidence of Kaposi's increased or decreased? How much has prevalence declined? Who is still at greatest risk?
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Decreased since use of HAART, prevalence has declined 10% but MSM still remain greatest risk group
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What does Kaposi look like histologically?
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Proliferation of small capillaries and spindle cells of endothelial origin. MNC infiltrate, RBC, spindle cells
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What are the 4 ways to transmit Kaposi's?
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1) Sexual (semen, saliva) - **PRIMARILY MSM 2) Parenteral (IV drug users) 3) Organ transplant 4) Salivary (mom-child post-partum, kissing?)
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AIDS related Kaposi's sarcoma: how does most of it manifest?
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Single or multiple mucocutaneous lesions, including GI tract - 22% occurs as oral lesions
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What are the most common sites of Kaposi's sarcoma? Does it disseminate?
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Trunk, arms, head, neck. Disseminates widely to lymph nodes and internal organs
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What % of patients with Kaposi's skin sarcoma have oral Kaposi's?
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>50%
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What % of patients only have oral Kaposi's with no skin involvement?
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10-20%
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Where does oral Kaposi's primarily occur?
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Hard and soft palate, sometimes tongue, gingiva, buccal mucosa
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What are Kaposi's sacoma lesions like?
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Red-brown-purple discoloration, may be multiple, bleeding is frequent
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When Kaposi's is seen on the tongue, what can it coinfect with?
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Candidiasis
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What is treatment for Kaposi's?
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Radiation, cytotoxics, alpha interferon
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After Kaposi's sarcoma, what are the next highest lymphoma risks?
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Non-Hodgkins Lymphoma - 165, Hodgkins disease - 8
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Lymphomas are the __th most common malignancy worldwide
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7
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How many new cases of lymphomas are there every year in the US?
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50,000
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Lymphomas occur in __% of HIV+ subjects without HAART
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10%
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What are the 2 major groups of lymphoma?
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1) Non-Hodgkins (NHL), includes Burkitt's, and 2) Hodgkins
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In 2009, how many new cases of all cancers were there? How many deaths?
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~1.5 million. ~ .5 million
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In 2009, how many new cases of NHL were there? Deaths?
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~66,000. ~21,000 (30% mortality rate)
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In 2009, how many new cases of Hodgkins were there? Deaths?
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~8,500. ~1,300
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What is the second most common lymphoma found in AIDS patients?
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AIDS-related lymphoma
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AIDS related lymphoma is less common in which patients?
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Patients with CCR5delta32 mutation
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T or F: non-Hodgkins lymphoma is an AIDS defining condition
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TRUE
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Is Hodgkin's lymphoma considered AIDS defining?
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No - it's AIDS associated, but not AIDS defining
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1) Has the incidence of NHL been increasing or decreasing in the HAART era?
2) Has incidence of HL been increasing or decreasing in the HAART era? |
1) Decreasing
2) Increasing |
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What are the clinical presentations of AIDS-related lymphoma?
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Weight loss, sweating, fever, 60% have advanced disease and extra-nodal involvement at presentation.
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AIDS-related lymphomas attack what part of the body most frequently? What % are intraoral?
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GI tract, brain most common. 5% are intraoral.
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System non-Hodgkins lymphoma comprises __% of all AIDS related lymphomas.
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80%
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What part of the body does systemic non-Hodkins lymphoma attack? What is the most common extranodal site affected?
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Lymph nodes, as well as extranodal, visceral sites. CNS is the most common extranodal site affected, followed by GI tract.
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What type of lymphoma is 1000x more common in patients with AIDS than in the general population?
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Primary CNS lymphoma
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A vast majority of non-Hodgkin lymphomas are what type?
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Aggressive B cell tumors
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What virus' genome is found in approximately 50% of the systemic B cell lymphomas and in virtually all primary CNS lymphomas?
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EBV genome
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AIDS related oral lymphoma
1) What is it? 2) Where is it found? 3) Is it nodal? 4) How fatal is it? 5) Treatment? |
1) Fast growing mass, ulcerates, necrosis
2) Palate, tongue, gingiva 3) **NON NONDAL** 4) Extremely - fatal within 8 months, especially when CD4 count is <100/ul 5) Chemotherapy, radiation |
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In AIDS patients, squamous cell carcinoma develops without?
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1) Pre-malignant conditions (leukoplakia, erythroplakia
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Where does squamous cell carcinoma usually develop?
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Tongue
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What plays a role in development of squamous cell carcinoma?
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Co-carcinogenic factors
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What is the treatment for squamous cell carcinoma?
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Radiation and/or surgery
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How does the prognosis of HIV+ patients with squamous cell carcinoma compare to HIV-?
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Worse!
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HPV associated squamous cell cervical come from what strains?
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HPV 16, 18. HPV squamous cell cancer is AIDS defining.
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Is ano-rectal HPV squamous cell carcinoma AIDS defining?
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NO
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Is HPV cervical squamous cell carcinoma AIDS defining?
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YES
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Has the following increased or decreased in the HAART era:
1) Kaposi sarcoma 2) Anal cancer 3) Non-Hodgkin lymphoma 4) Colon cancer 5) Cervical cancedr 6) Hodgkin lymphoma |
1) Decreased
2) Increased 3) Decreased 4) Increased 5) Decreased 6) Increased |
