1/64. role of human papillomavirus typing in diagnosis and clinical decision making for a giant verrucous genital lesion.A 60-year-old man presented with a 12.0 x 10.0-cm exophytic, verrucous genital plaque. Multiple biopsy specimens were evaluated by standard histologic analysis and polymerase chain reaction assays for human papillomavirus (HPV) deoxyribonucleic acid. All biopsy specimens showed histopathologic changes consistent with giant condyloma of Buschke-Lowenstein (GCBL), were uniformly positive for HPV 6/11, and showed a weaker signal for HPV 16. Published reports suggest that the presence of HPV may be useful in differentiating GCBL from verrucous carcinoma (VC), but absence of "high-risk" HPV types in GCBL cannot exclude focally invasive squamous cell carcinoma. Screening for HPV may be a helpful adjunct in differentiating GCBL from VC, but histopathologic criteria for malignancy should take precedence over HPV typing when determining management.- - - - - - - - - - ranking = 1keywords = acid (Clic here for more details about this article) |
2/64. Epstein-Barr virus-associated intravascular lymphomatosis within Kaposi's sarcoma in an AIDS patient.Intravascular lymphomatosis (IL) is an unusual neoplasm characterized by multifocal proliferation of lymphoma cells exclusively within the blood vessels. We report here a patient with acquired immunodeficiency syndrome (AIDS) and disseminated Kaposi's sarcoma. A 233-bp amplification product of HHV-8 was detected in the DNA extracted from specimens of Kaposi's sarcoma at different sites by polymerase chain reaction (PCR). At autopsy, the vessels within the Kaposi's sarcoma were dilated and filled with atypical large mononuclear cells. No such feature was seen in the vessels of non-Kaposi's sarcomatous regions. Immunohistochemically, the spindle cells of Kaposi's sarcoma were positive for CD31 (endothelial cell marker). The intravascular tumor cells were positive for CD45 (leukocyte common antigen) but negative for others, including chloroacetate esterase, CD45-RO (UCHL-1, Pan-T), CD3, CD43, CD20 (L26, Pan-B), CD30 (Ki-1), immunoglobulin heavy chains and light chains, CD56 (natural killer cell antigen), and CD31. Monoclonal rearrangement of immunoglobulin heavy chain gene was detected in the DNA extracts from fresh tissue of Kaposi's sarcoma by PCR, which indicated that the lymphoma cells within the Kaposi's sarcoma were of monoclonal B cell origin. in situ hybridization revealed that EBER-1 transcripts were present in the lymphoma cells of IL but not in the spindle cells of Kaposi's sarcoma. To the authors' best knowledge, this is the first instance of IL in an AIDS patient with direct evidence of EBV association.- - - - - - - - - - ranking = 3645.5980257117keywords = amplification (Clic here for more details about this article) |
3/64. Immunomodulatory treatment with low-dose interferon-alpha and oral retinoic acid in lymphangioma-like Kaposi's sarcoma.BACKGROUND: The presence of lymphangiectasis without the characteristic spindle cell proliferation may lead to diagnostic difficulties in Kaposi's sarcoma. Although the literary data mention that the lymphangioma-like tumors may occur in Kaposi's sarcoma, there have been few specific reports and case presentations published. OBSERVATIONS: A case of lymphangioma-like Kaposi's sarcoma in association with IgG/lambda type paraproteinaemia is reported in a 60-year-old man. The HSV8 DNA sequence could be detected by PCR analysis from lesional skin. CONCLUSION: The beneficial effect of alpha-2 interferon (4.5 million units per week) combined with retinoic treatment (0.5 mg/body weight of isotretinoin) caused the regression of the skin rashes while improving the values of immunological tests (T cell function, quantity of paraproteins). The patient's improved general condition and the ameliorating immunological parameters were due to the combination of two regimens applied in a low-dose the alpha-2 interferon (tumor regression) and the oral isotretinoid (antitumor activity, reduction of IL-6 receptor display) treatment.- - - - - - - - - - ranking = 4keywords = acid (Clic here for more details about this article) |
4/64. Increased expression of vascular endothelial growth factor (VEGF) in Castleman's disease: proposed pathomechanism of vascular proliferation in the affected lymph node.Castleman's disease is a lymphoproliferative disorder of unknown etiology characterized by enlarged hyperplastic lymph nodes with marked vascular proliferation. To evaluate the possible involvement of vascular endothelial growth factor (VEGF) in the pathogenesis of Castleman's disease, we studied VEGF expression in sera and lymph nodes from four patients with either the plasma-cell type or mixed type of Castleman's disease. Clinically, one patient had the multicentric type and the others the localized type. The VEGF levels of the sera and the supernatants of the cultured lymph nodes were higher than those of normal controls. VEGF was strongly expressed in plasma cells in the interfollicular region of the lymph nodes, but rarely in normal lymph nodes. The disregulated IL-6 gene expression is considered to be a primary event that could be related to the etiology of this disease. Recently, Kaposi's sarcoma virus/human herpes virus 8 (KSHV/HHV-8) has been reported to be associated with a subset of the multicentric type of Castleman's disease, and a viral homologue of IL-6 (vIL-6) encoded by KSHV/HHV-8 has been shown to induce VEGF expression. Human IL-6 produced in the affected lymph nodes of Castleman's disease may induce paracrine VEGF-production by plasma cells and vascular proliferation in the lymph node. The confirmation of the role of VEGF in the pathogenesis of Castleman's disease may provide a therapeutic strategy.- - - - - - - - - - ranking = 63.919217426793keywords = rna (Clic here for more details about this article) |
5/64. Self-administered topical imiquimod treatment of vulvar intraepithelial neoplasia. A report of four cases.BACKGROUND: Vulvar intraepithelial neoplasia (VIN) generally can be classified into viral and nonviral etiologies. The histopathologic diagnosis is often separable into basaloid and warty types. A large percentage of VIN lesions have been shown to harbor human papillomavirus (HPV), principally type 16. Imiquimod, an immune response modifier, has been shown to be safe and effective for the treatment of external and perianal genital warts caused by HPV. CASES: Four cases occurred of clinical and histopathologically diagnosed viral VIN 3. An imiquimod treatment protocol, previously used in a study of this drug for the treatment of external genital warts, was followed. Imiquimod 5% cream was patient applied three times per week until all lesions cleared, for a maximum of 16 weeks. CONCLUSION: Imiquimod may be an effective treatment modality for viral VIN 3 in the future.- - - - - - - - - - ranking = 127.83843485359keywords = rna (Clic here for more details about this article) |
6/64. Successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta.We report the successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta (Fiblaferon gel). Topical treatment with interferon-beta appears to be an effective, simple, non-invasive, cheap and low-risk alternative to other invasive or surgical therapeutic modalities.- - - - - - - - - - ranking = 63.919217426793keywords = rna (Clic here for more details about this article) |
7/64. Tissue-specific expression of SV40 in tumors associated with the li-fraumeni syndrome.Inactivation of wild-type p53 tumor suppressor function is the primary mechanism of tumor initiation in li-fraumeni syndrome (LFS) individuals with germline p53 mutations. Tumors derived from LFS patients frequently retain the normal p53 allele, suggesting that alternative mechanisms in addition to gene deletion must be involved in inactivating wild-type p53 protein. dna tumor viruses, such as SV40, target p53 for inactivation through the action of viral oncoproteins. We studied the probands from two unrelated LFS families, each of whom presented with multiple malignant neoplasms. Patient 1 developed an embryonal rhabdomyosarcoma (RMS) and a choroid plexus carcinoma (CPC), while patient 2 developed a CPC and subsequently presented with both an osteosarcoma (OS) and renal cell carcinoma (RCC). We utilized DNA sequence analysis and immunohistochemistry to determine p53 gene status in the germline and tumors, as well as evidence for SV40 T-antigen oncoprotein expression. Each patient harbored a heterozygous germline p53 mutation at codons 175 and 273, respectively. In patient 1, the normal p53 gene was lost while the mutant p53 allele was reduced to homozygosity in the RMS. Both normal and mutant genes were maintained in the CPC. In patient 2, normal and mutant p53 alleles were retained in both the CPC and RCC. Both specific PCR and immunostaining detected SV40 T-antigen in both CPCs and the RCC. In addition to chromosomal alterations, epigenetic mechanisms may disrupt p53 function during tumorigenesis. In two LFS patients, we found SV40 DNA sequences and viral T-antigen expression that could account for inactivation of the normal p53 protein. Inactivation of p53 or other tumor suppressors by viral proteins may contribute to tumor formation in specific tissues of genetically susceptible individuals.- - - - - - - - - - ranking = 63.919217426793keywords = rna (Clic here for more details about this article) |
8/64. Evidence for the presence of neutralizing antibodies against human papillomavirus type 6 in infants born to mothers with condyloma acuminata.Despite human papillomavirus type 6 or 11 (HPV6/11) being often vertically transmitted from mothers with condyloma acuminata (CA) to their infants, HPV-related neonatal mucosal diseases are rare. The role of maternal anti-HPV6/11 neutralizing antibodies in preventing the vertical transmission remains to be unknown because of lack of the neutralization assay system of HPV infection. We experienced two cases of HPV6-positive CA during pregnancy. Neutralizing antibodies against HPV6 in maternal, umbilical, and infantile sera were determined using a surrogate assay system to monitor HPV6 pseudo-infections. The neutralizing antibodies were detected in maternal and umbilical sera and in serum of one of the infants tested at 5 weeks old. In the infant exposed to HPV6 at birth, viral DNA was not detectable in the oral cavity 5 weeks after birth. This is the first report to describe that neutralizing antibodies against HPV6 in mothers with CA go through the placenta and enter the circulation of their infants. These data may provide a mechanistic paradigm for the prevention of its vertical transmission.- - - - - - - - - - ranking = 191.75765228038keywords = rna (Clic here for more details about this article) |
9/64. heart allograft involvement with Epstein-Barr virus-associated posttransplant lymphoproliferative disorder.We describe a 60-year-old man who underwent heart transplant and died 5 months later. At autopsy, the patient was found to have posttransplant lymphoproliferative disorder (PTLD), which was not suspected ante mortem. The PTLD involved the lung, lymph nodes, spleen, and kidney and the intima of right coronary artery of the transplanted heart. Epstein-Barr virus infection was demonstrated on direct gel and dot blot after polymerase chain reaction amplification. in situ hybridization for Epstein-Barr virus DNA confirmed the presence of Epstein-Barr virus-infected lymphocytes in the intima of the right coronary artery of the cardiac allograft. To our knowledge, this case represents the first report of involvement of a heart allograft by PTLD in which Epstein-Barr virus infection of the atypical cells is documented. Although primary allograft involvement by PTLD has rarely been reported in heart transplant recipients, recognition that this may occur is important, since the lymphoid infiltrate of PTLD must be distinguished from the lymphoid infiltrate of acute rejection to avoid inappropriate therapy.- - - - - - - - - - ranking = 3645.5980257117keywords = amplification (Clic here for more details about this article) |
10/64. Fatal maternal laryngeal papillomatosis in pregnancy: a case report [corrected]Although genital condylomata worsen with pregnancy, we are unaware of any reports of fatal maternal laryngeal papillomatosis. A maternal death at 20 weeks' gestation of a patient with chronic laryngeal papillomatosis is described. Pregnant patients with a history of this disorder who have symptoms should be considered candidates for immediate evaluation.- - - - - - - - - - ranking = 383.51530456076keywords = rna (Clic here for more details about this article) |
| | Next -> |