==================================CMR56================================== 56. AIDS (Acquired immunodeficiency syndrome). Malignancies occuring in the AIDS population base. - Kaposi's sarcomas - Squamous cell carcinomas - Carcinoma- any - Malignant Lymphoma - Hodgkin's Disease 1 UI - 87114218 AU - Gallo RC TI - HTLV: the family of human T-lymphotropic retroviruses and their role in leukemia and AIDS. AB - Since 1980 four members of a new retrovirus family called the human T-lymphotropic viruses (HTLV-I to -IV) have been discovered and to a large extent characterised. Important common features of these viruses are: transmission by sexual contact or blood, tropism for the T4-lymphocyte and the effects of a viral transactivating gene (tat). They differ in their pathogenic effects, HTLV-I and -II being associated with lymphoproliferative malignancies, while HTLV-III is cytopathic and associated with immunosuppression. HTLV-IV is, apparently, not directly highly pathogenic for man. An African origin for this family of viruses is suggested by recent isolations of similar (STLV-I and -III) viruses in Old World primates. Prospects for the possible development of a cross-reactive vaccine have increased since the demonstration of highly conserved DNA sequences in the envelope region of several divergent HTLV-III strains. MH - Acquired Immunodeficiency Syndrome/*MICROBIOLOGY ; *Human T-Cell Leukemia Virus ; Human ; HTLV Infections/FAMILIAL & GENETIC/ PREVENTION & CONTROL ; Leukemia/*MICROBIOLOGY ; Review SO - Med Oncol Tumor Pharmacother 1986;3(3-4):265-7 2 UI - 87109947 AU - Penneys NS ; Kott-Blumenkranz R ; Civantos F ; Kent J TI - von Willebrand factor antigen levels in Kaposi's sarcoma. AB - Consistent elevations of plasma von Willebrand factor antigen were observed in otherwise healthy elderly patients with Kaposi's sarcoma. The elevations were predominantly of the endothelial cell--derived antigen, as opposed to the factor VIII procoagulant, with resultant elevations in the antigen/procoagulant ratios. Lesser elevations were seen in a group of age-matched control subjects who did not have Kaposi's sarcoma or intercurrent illness. The greater elevations in plasma von Willebrand factor antigen therefore appear to be the direct consequence of the presence of Kaposi's sarcoma cells. Our findings also suggest that there is a direct relationship between tumor load and degree of von Willebrand factor antigen elevation. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY ; Aged ; Aged, 80 and over ; Antigens/*ANALYSIS ; Factor VIII/ANALYSIS ; Female ; Human ; Male ; Middle Age ; Opportunistic Infections/IMMUNOLOGY ; Sarcoma, Kaposi's/*IMMUNOLOGY ; Skin Neoplasms/*IMMUNOLOGY SO - J Am Acad Dermatol 1986 Dec;15(6):1214-7 3 UI - 87097311 AU - Afrasiabi R ; Mitsuyasu RT ; Nishanian P ; Schwartz K ; Fahey JL TI - Characterization of a distinct subgroup of high-risk persons with Kaposi's sarcoma and good prognosis who present with normal T4 cell number and T4:T8 ratio and negative HTLV-III/LAV serologic test results. AB - Three homosexual male patients with biopsy-proved Kaposi's sarcoma were classified as having the acquired immune deficiency syndrome (AIDS) by Centers for Disease Control criteria when first seen in 1983 and 1984. These patients, however, differed from most patients with AIDS and Kaposi's sarcoma in having normal CD4 cell numbers and normal CD4:CD8 ratio. Furthermore, these immunologic parameters remained normal for eight to 24 months of follow-up, and the disease did not progress. Results of recent testing of serum from these patients were negative for HTLV-III/LAV antibodies. The Kaposi's sarcoma was limited to skin (stage I tumors) and the patients did not have persistent lymphadenopathy, fever, night sweats, or weight loss. In contrast to AIDS, the serum immunoglobulin levels (IgG, IgA, IgM) and number of B cells that were spontaneously forming immunoglobulin were within normal range with no evidence of polyclonal activation. The lymphocyte proliferative responses to phytohemagglutinin and Candida were reduced in two of the three patients, and skin test anergy was observed in the two patients tested. These findings are not frequently encountered in other healthy, homosexually active men or in classic Kaposi's sarcoma. They may be indicative of functional T cell changes (without numerical changes) induced by factors other than HTLV-III/LAV virus, which made these homosexually active men susceptible to development of low-grade Kaposi's sarcoma lesions. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*IMMUNOLOGY ; Adult ; Antibodies, Viral/*ANALYSIS ; Enzyme-Linked Immunosorbent Assay ; Helper Cells/IMMUNOLOGY ; Human ; Hypersensitivity, Delayed/IMMUNOLOGY ; HTLV-III/*IMMUNOLOGY ; Immunoglobulins/ ANALYSIS ; Leukocyte Count ; Lymphocyte Transformation ; Male ; Middle Age ; Prognosis ; Sarcoma, Kaposi's/COMPLICATIONS/ *IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Med 1986 Dec;81(6):969-73 4 UI - 87097286 AU - Prior E ; Goldberg AF ; Conjalka MS ; Chapman WE ; Tay S ; Ames ED TI - Hodgkin's disease in homosexual men. An AIDS-related phenomenon? AB - Five cases of Hodgkin's disease in young homosexual men at risk for the acquired immune deficiency syndrome (AIDS) are reported. The mixed cellularity histologic subtype was present in each. Two also showed features of lymphocyte depletion. Four of the five patients had pathologic stage IIIB or IVB disease at presentation. In the fifth, recurrent Hodgkin's disease developed in a previously irradiated field. Three patients had opportunistic infections characteristic of AIDS. Hodgkin's disease may pursue a more fulminant course in patients at risk for AIDS and may itself be a manifestation of AIDS in this high-risk population. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Case Report ; Hodgkin's Disease/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY ; Human ; Lymphopenia/IMMUNOLOGY ; Male ; Neoplasm Staging ; Opportunistic Infections/IMMUNOLOGY ; Risk SO - Am J Med 1986 Dec;81(6):1085-8 5 UI - 87074738 AU - So YT ; Beckstead JH ; Davis RL TI - Primary central nervous system lymphoma in acquired immune deficiency syndrome: a clinical and pathological study. AB - Twenty cases of primary lymphoma of the central nervous system associated with acquired immune deficiency syndrome were seen over a period of four years and were studied clinically and pathologically. Biopsy established the diagnosis in 11 cases, and autopsy confirmed it in 9. Multicentricity was demonstrated in all cases for which there was adequate autopsy material. Both large-cell immunoblastic and small noncleaved lymphomas were seen, and marker studies in 5 patients established that the lymphomas were of B-cell origin. Neurological symptoms and signs, cerebrospinal fluid characteristics, and radiographic appearance were reviewed. The clinical and radiographic picture is nonspecific and histological confirmation is essential for diagnosis. Although the tumor appears to be radiosensitive, prognosis is extremely poor, with an average survival of less than two months. MH - Acquired Immunodeficiency Syndrome/CEREBROSPINAL FLUID/ *COMPLICATIONS ; Adult ; Brain Neoplasms/ETIOLOGY/*PATHOLOGY ; Brain/PATHOLOGY/RADIOGRAPHY ; Human ; Lymphoma/*ETIOLOGY/ PATHOLOGY ; Male ; Middle Age ; Nuclear Magnetic Resonance/ DIAGNOSTIC USE ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; Tomography, X-Ray Computed SO - Ann Neurol 1986 Nov;20(5):566-72 6 UI - 87063012 AU - Brooks JJ TI - Kaposi's sarcoma: a reversible hyperplasia. AB - Kaposi's sarcoma has many unusual features: for example, the pronounced male preponderance; its appearance in "crops: rather than as primary tumour with metastases; a substantial rate of spontaneous remission; the predictability of involved sites; the lack of aneuploidy; and the strong association with immunodeficiency. These features and other evidence suggest that it is not a malignant neoplasm but a benign, potentially controllable and reversible hyperplasia. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Human ; Hyperplasia ; Male ; Neoplasm Regression, Spontaneous ; Sarcoma, Kaposi's/ETIOLOGY/*PATHOLOGY/PHYSIOPATHOLOGY SO - Lancet 1986 Dec 6;2(8519):1309-11 7 UI - 87051352 AU - Delli Bovi P ; Donti E ; Knowles DM 2d ; Friedman-Kien A ; Luciw PA ; Dina D ; Dalla-Favera R ; Basilico C TI - Presence of chromosomal abnormalities and lack of AIDS retrovirus DNA sequences in AIDS-associated Kaposi's sarcoma. AB - The frequent occurrence of Kaposi's sarcoma (KS) in association with the acquired immune deficiency syndrome (AIDS) could be due to the fact that the etiological agent of this tumor is the same retrovirus causing AIDS, to another oncogenic virus frequently found in AIDS patients, or to the unmasking of the tumorigenic potential of KS cells by immunosuppression. We have therefore investigated the presence of DNA sequences homologous to the AIDS retrovirus, cytomegalovirus (CMV), and hepatitis B virus in 13 KS necropsies and biopsies from AIDS patients. All KS DNA samples were negative for AIDS retrovirus or hepatitis B DNA sequences. Two DNAs from necropsies contained CMV DNA, but the data suggested the presence of replicating CMV DNA due to generalized infection. We have also studied cell cultures derived from KS skin biopsies of AIDS patients. These cultures had a short lifetime in vitro and expressed some markers of endothelial cells. The cells were not tumorigenic in nude mice but contained a number of chromosomal rearrangements which were often monoclonal within the same culture. However, these abnormalities were different from culture to culture and even in cultures from the same biopsy. The presence of these chromosomal abnormalities seemed to correlate with the cell positivity for endothelial markers. Taken together these results indicate that neither the AIDS retrovirus, CMV, or hepatitis B virus is directly responsible for the altered growth of KS cells, that KS may be polyclonal even within the same lesion, and that KS cells have a tendency to karyotypic rearrangements. MH - Acquired Immunodeficiency Syndrome/*FAMILIAL & GENETIC ; Base Sequence ; Cells, Cultured ; *Chromosome Aberrations ; Cytomegaloviruses/GENETICS ; DNA, Viral/*ANALYSIS ; Factor VIII/ ANALYSIS ; Hepatitis B Virus/GENETICS ; Human ; HLA-DR Antigens/ ANALYSIS ; HTLV-III/*GENETICS ; Recombination, Genetic ; Sarcoma, Kaposi's/*FAMILIAL & GENETIC/IMMUNOLOGY/PATHOLOGY ; Support, U.S. Gov't, P.H.S. SO - Cancer Res 1986 Dec;46(12 Pt 1):6333-8 8 UI - 87051272 AU - Lotze MT ; Matory YL ; Rayner AA ; Ettinghausen SE ; Vetto JT ; Seipp CA ; Rosenberg SA TI - Clinical effects and toxicity of interleukin-2 in patients with cancer. AB - Interleukin-2 (IL-2) is a 15,000 dalton glycoprotein produced naturally by human T-cells during an immune response. IL-2 has been demonstrated to have substantial activity alone or in combination with the adoptive transfer of lymphokine-activated killer cells in murine tumor models. IL-2 derived from both natural (Jurkat human T-cell tumor) and recombinant (Escherichia coli) sources has been studied in Phase I protocols designed to evaluate toxicity in patients with a variety of solid tumors and to ascertain improvement in clinical parameters and immunologic status. A total of 16 patients (7 with acquired immune deficiency syndrome [AIDS] and 9 with non-AIDS malignancies) were treated with Jurkat derived IL-2. The total maximum dose (1.3 X 10(5) U/kg) was limited only by supply of this reagent. A total of 25 patients have been treated with recombinant IL-2 (RIL-2) alone. Dose-limiting toxicity manifested by marked malaise and weight gain was achieved with doses of RIL-2 of 10(6) U/kg as a single bolus or 3000 U/kg/hr. IL-2 could be administered intraperitoneally with similar toxicity. Minimal renal or hepatic toxicity was demonstrated. Hematologic toxicity was limited to mild anemia (25/25), thrombocytopenia (10/25), and marked reversible eosinophilia (15/25). Pronounced weight gain greater than 2 kg (16/25) occurred in most patients, primarily those who received cumulative doses of greater than 1-3 X 10(5) U/kg of IL-2. The weight gain amounted to as much as 10% to 20% of the pretreatment weight over 3 weeks of treatment and limited our ability to give higher doses. Two partial responses (greater than 50% decrease in cross sectional diameters) were seen in two patients with melanoma metastatic to the lung. MH - Acquired Immunodeficiency Syndrome/THERAPY ; Adult ; Aged ; Biopsy ; Body Weight ; Bone Marrow/DRUG EFFECTS ; Evaluation Studies ; Female ; Human ; Interleukin 2/ADMINISTRATION & DOSAGE/ TOXICITY/*THERAPEUTIC USE ; Kidney/DRUG EFFECTS ; Liver/DRUG EFFECTS ; Male ; Middle Age ; Neoplasms/*THERAPY ; Recombinant Proteins/TOXICITY/THERAPEUTIC USE ; Skin/PATHOLOGY SO - Cancer 1986 Dec 15;58(12):2764-72 9 UI - 87048539 AU - Thomas MA ; Ibels LS ; Wells JV ; Isbister JP ; Cooper DA ; McMahon C TI - IgA kappa multiple myeloma and lymphadenopathy syndrome associated with AIDS virus infection. AB - A 29 year old homosexual male presented with acute renal failure caused by acute myeloma. Subsequent investigation demonstrated antibody to the AIDS-associated virus human T-cell lymphotropic virus III, (HTLV-III/LAV/ARV). The association between lymphadenopathy syndrome and multiple myeloma is discussed. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; AIDS-Related Complex/*COMPLICATIONS ; Case Report ; Human ; IgA/ *IMMUNOLOGY ; Immunoglobulins, Kappa Chain/*IMMUNOLOGY ; Kidney Failure, Acute/ETIOLOGY ; Male ; Multiple Myeloma/*ETIOLOGY ; Support, Non-U.S. Gov't SO - Aust NZ J Med 1986 Jun;16(3):402-4 10 UI - 87047990 AU - Di Carlo EF ; Amberson JB ; Metroka CE ; Ballard P ; Moore A ; Mouradian JA TI - Malignant lymphomas and the acquired immunodeficiency syndrome. Evaluation of 30 cases using a working formulation. AB - Malignant lymphomas occurring in 29 homosexual men and one thalassemic woman with the acquired immunodeficiency syndrome or the acquired immunodeficiency syndrome-related complex are reported using a working formulation for non-Hodgkin's lymphomas (NHLs). The patients' ages ranged from 25 to 59 years, with an average age of 42 years. Ninety percent of the cases were extranodal; 67% were exclusively extranodal. One case of Hodgkin's disease was encountered. All NHLs were of the diffuse types in both the intermediate- and high-grade categories, with the largest single group (49%) being of the diffuse, large, follicular-center-cell types. The NHLs in this series were classifiable as B-cell neoplasms and were aggressive as evidenced by markedly reduced median survivals. The morphological diagnosis as defined in the working formulation, especially for the intermediate-grade lesions, offered little significant prognostic information. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; AIDS-Related Complex/COMPLICATIONS ; Burkitt's Lymphoma/ COMPLICATIONS/PATHOLOGY ; Female ; Hodgkin's Disease/ COMPLICATIONS/PATHOLOGY ; Human ; Lymph Nodes/PATHOLOGY ; Lymphoma, Non-Hodgkin's/*COMPLICATIONS/PATHOLOGY ; Male ; Middle Age ; Support, Non-U.S. Gov't ; Thalassemia/COMPLICATIONS ; Tissue Distribution SO - Arch Pathol Lab Med 1986 Nov;110(11):1012-6 11 UI - 87047111 AU - Barrio JL ; Suarez M ; Rodriguez JL ; Saldana MJ ; Pitchenik AE TI - Pneumocystis carinii pneumonia presenting as cavitating and noncavitating solitary pulmonary nodules in patients with the acquired immunodeficiency syndrome. AB - Among 150 cases of microscopically proved Pneumocystis carinii pneumonia secondary to the acquired immunodeficiency syndrome (AIDS) seen by our pulmonary service from January 1982 to January 1986, P. carinii presented roentgenographically as a solitary pulmonary nodule in 2 patients (1.3%). It was the sole cause of the nodules as determined by clinical and roentgenographic response to specific drug therapy, examination of specimens obtained at fiberoptic bronchoscopy, and examination of lung specimens obtained at autopsy. In one of the patients, the nodule appeared to develop a large central cavity, which was confirmed at autopsy. In patients with AIDS, a solitary pulmonary nodule with or without cavitation may rarely represent P. carinii pneumonia. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Case Report ; Coin Lesion, Pulmonary/*DIAGNOSIS ; Diagnosis, Differential ; Female ; Human ; Male ; Middle Age ; Pneumonia, Pneumocystis Carinii/COMPLICATIONS/*DIAGNOSIS/RADIOGRAPHY ; Thoracic Radiography SO - Am Rev Respir Dis 1986 Nov;134(5):1094-6 12 UI - 87046085 AU - Duncan ED ; Miller HJ ; McKeever WP TI - Non-Hodgkin's lymphoma, HTLV-III/LAV, and HTLV-III/LAV antibody in the wife of a man with transfusion-acquired AIDS. AB - Non-Hodgkin's lymphoma of the small intestine developed in a 66-year-old woman who was the wife of a man with transfusion-related acquired immune deficiency syndrome (AIDS). Antibody to the human T lymphotrophic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) was present in her serum, and the virus was isolated from her peripheral lymphocytes. The possibility that the non-Hodgkin's lymphoma in this patient was a manifestation of HTLV-III/LAV infection is discussed. This is believed to be the first reported case of lymphoma occurring in a patient with documented HTLV-III/LAV infection outside the male homosexual risk group. MH - Acquired Immunodeficiency Syndrome/BLOOD/*COMPLICATIONS ; Aged ; Antibodies, Viral/*ANALYSIS ; Case Report ; Female ; Human ; HTLV-III/*IMMUNOLOGY ; Lymphoma, Non-Hodgkin's/BLOOD/*ETIOLOGY ; Male SO - Am J Med 1986 Nov;81(5):898-900 13 UI - 87046065 AU - Ikossi-O'Connor MG ; Chadha KC ; Lillie MA ; Bernstein Z ; Zucker-Franklin D ; Ambrus JL TI - Interferon inactivator(s) in patients with AIDS and AIDS-unrelated Kaposi's sarcoma. AB - Interferon inhibitory activity was found in the plasma of 11 of 14 patients with the acquired immune deficiency syndrome (AIDS). This was not seen in 75 normal persons, including six whose specimens were randomly and blindly interspersed among the patient samples. Plasma from a single patient with the AIDS prodrome (AIDS-related complex), who later demonstrated AIDS, did not contain interferon inhibitors but did contain high levels of interferon. Three patients with AIDS-unrelated Kaposi's sarcoma had neither significant levels of interferon nor interferon inhibitory activity. The existence of interferon inhibitory activity in the plasma has to be taken into account when interferon preparations are administered therapeutically. MH - Acquired Immunodeficiency Syndrome/*BLOOD ; Adult ; Aged ; AIDS-Related Complex/BLOOD ; Clinical Trials ; Double-Blind Method ; Human ; Interferons/*ANTAGONISTS & INHIBITORS/BLOOD ; Male ; Middle Age ; Sarcoma, Kaposi's/*BLOOD ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Med 1986 Nov;81(5):783-5 14 UI - 87036932 AU - Wernicke D ; Trainin Z ; Ungar-Waron H ; Essex M TI - Humoral immune response of asymptomatic cats naturally infected with feline leukemia virus. AB - The humoral immune response of cats that were naturally infected with the feline leukemia virus (FeLV) was examined after antigenic stimulation with the synthetic antigen poly(L-Tyr, L-Glu)-poly(DL-Ala)-poly(L-Lys). The primary humoral antibody response in FeLV-infected cats was both delayed and greatly reduced, compared with that seen in uninfected control cats. A similar discordance was observed after secondary stimulation with the antigen, in the FeLV-infected cats had both a delayed response and a reduced response, compared with uninfected cats. The levels of total immunoglobulins of the immunoglobulin G and immunoglobulin M classes in the sera of FeLV-infected cats were significantly higher (two- and threefold, respectively) than were those of the uninfected control animals. The presence of an impaired humoral immune response to newly presented antigens in the presence of elevated immunoglobulin levels has been thoroughly documented in the case of people with the acquired immunodeficiency syndrome. This further emphasizes the potential value of FeLV-infected cats as a model for human acquired immunodeficiency syndrome. MH - Acquired Immunodeficiency Syndrome ; Animal ; Antibody Formation ; Cats ; Disease Models, Animal ; Feline Leukemia Virus ; IgG/ ANALYSIS/BIOSYNTHESIS ; IgM/ANALYSIS/BIOSYNTHESIS ; *Immune Tolerance ; Immunization ; Immunization, Secondary ; Leukemia, Experimental/*IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - J Virol 1986 Nov;60(2):669-73 15 UI - 87036699 AU - Otu AA TI - Kaposi's sarcoma and HTLV-III: a study in Nigerian adult males. AB - Sera from 37 adult Nigerian men with Kaposi's sarcoma (KS), 30 contemporaneous controls bearing primary cell carcinoma of the liver (PCL), and 150 healthy non-tumour-bearing negative controls were tested for antibody to human T-cell lymphotropic virus type III/lymphadenopathy associated virus (HTLV-III/LAV) by enzyme-linked immunosorbent assays (ELISA). Certain immunocellular functions were also measured: the chemotactic locomotion of peripheral blood monocytes towards casein, delayed-type cutaneous hypersensitivity reaction to tuberculoprotein and opportunistic infection with the fungus Candida albicans. Sera from all these groups were also tested for markers of previous infections with the viruses cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B (HBV) and hepatitis A (HAV). All serum samples tested were reproducibly and consistently negative for anti-HTLV-III/LAV. Peripheral blood monocytes from both KS and PCL patients showed profound depression of chemotaxis; similarly all tumour patients gave markedly depressed cutaneous reactivity to tuberculoprotein and uniformly exhibited seropositivity to CMV, EBV, HBV and HAV. A great majority showed evidence of infection with Candida albicans. It is concluded that tropical African KS is not associated with HTLV-III/LAV infection. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*IMMUNOLOGY ; Adult ; Antibodies, Viral/ANALYSIS ; Candidiasis/COMPLICATIONS ; Chemotaxis, Leukocyte ; Cytomegaloviruses/IMMUNOLOGY ; Epstein-Barr Virus/IMMUNOLOGY ; Female ; Hepatitis, Viral, Human/ COMPLICATIONS ; Hepatoma/IMMUNOLOGY ; Herpesvirus Infections/ COMPLICATIONS ; Human T-Cell Leukemia Virus/IMMUNOLOGY ; Human ; Hypersensitivity, Delayed/IMMUNOLOGY ; Male ; Middle Age ; Nigeria ; Sarcoma, Kaposi's/COMPLICATIONS/*IMMUNOLOGY SO - J R Soc Med 1986 Sep;79(9):510-4 16 UI - 87023593 AU - Helsper J ; Formenti S ; Levine A TI - Initial manifestation of acquired immunodeficiency syndrome in the head and neck region. AB - Initial manifestation of AIDS in the head and neck region occurs frequently. The purpose of this report has been to alert the head and neck surgeon to the occurrence of AIDS-related lesions, their clinical characteristics, and disease outcome. Incomplete recognition of these disorders may delay appropriate diagnostic study and initiation of therapy. We have described 10 patients in whom the initial manifestation of AIDS-related malignancies occurred in the head and neck region. Six of these patients were found to have Kaposi's sarcoma, whereas four had non-Hodgkin's lymphomas. The specific clinical and pathologic aspects of the disease have been described, which represent common patterns of presentation. It is crucial to obtain an accurate social history, as well as a complete medical history from any patient suspected of having AIDS, and prompt biopsy of suspect lesions should be performed. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Biopsy ; Head and Neck Neoplasms/*ETIOLOGY/PATHOLOGY ; Homosexuality ; Human ; Lymph Nodes/PATHOLOGY ; Lymphoma, Non-Hodgkin's/*ETIOLOGY ; Male ; Middle Age ; Sarcoma, Kaposi's/ *ETIOLOGY/PATHOLOGY SO - Am J Surg 1986 Oct;152(4):403-6 17 UI - 87022686 AU - Levy RM ; Rosenbloom S ; Perrett LV TI - Neuroradiologic findings in AIDS: a review of 200 cases. AB - The radiologic studies of 200 consecutive AIDS patients with neurologic symptoms were evaluated to determine their diagnostic specificity and prognostic value. Of 81 patients with initially normal CT scans, four (5%) later developed progressive neurologic illness. Of 75 patients with CT evidence of diffuse cerebral atrophy, 12 (16%) later developed CT abnormalities or had postmortem CNS disease. CT scans showed mass lesions initially in 44 patients and later in an additional seven patients. Although toxoplasma gondii infection was the most frequent cause of these lesions, the CT characteristics of cerebral toxoplasmosis are too nonspecific to warrant diagnosis without biopsy. Preliminary evidence suggests that MRI may be more sensitive than CT in detecting intracranial disease in patients with AIDS. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY ; Adult ; Brain Abscess/ETIOLOGY/*RADIOGRAPHY ; Brain Neoplasms/ ETIOLOGY/*RADIOGRAPHY ; Central Nervous System Diseases/ RADIOGRAPHY ; Human ; Lymphoma/ETIOLOGY/*RADIOGRAPHY ; Male ; Middle Age ; Support, Non-U.S. Gov't ; Toxoplasmosis/ETIOLOGY/ *RADIOGRAPHY SO - AJR 1986 Nov;147(5):977-83 18 UI - 87022674 AU - Emery CD ; Wall SD ; Federle MP ; Sooy CD TI - Pharyngeal Kaposi's sarcoma in patients with AIDS. AB - The radiographic appearance of gastrointestinal Kaposi's sarcoma in patients with AIDS has been described previously, but little attention has been paid to pharyngeal involvement. This study compared the radiographic findings of pharyngeal Kaposi's sarcoma in eight patients with AIDS and dysphagia to those of visual inspection by laryngoscopy or bronchoscopy. Barium pharyngography (six patients) demonstrated nodular lesions without ulceration, ranging in extent from a single nodule to extensive confluent disease. CT (two patients) showed nodular or polypoid intraluminal protrusions, distortion of valleculae and pyriform sinuses, infiltration of deep-tissue planes, and adenopathy. A 4-mm nodular lesion was not seen on pharyngography. Radiographic evaluation provided supplemental information in six patients, especially regarding inferior extent of disease in four whose bulky lesions precluded adequate visual assessment. CT aided in defining deep-tissue-plane involvement and extent of nodal disease. It is concluded that barium pharyngography and CT are useful in the diagnostic evaluation of possible Kaposi's sarcoma in patients with AIDS and dysphagia. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Bronchoscopy ; Comparative Study ; Human ; Laryngoscopy ; Male ; Pharyngeal Neoplasms/COMPLICATIONS/*RADIOGRAPHY ; Sarcoma, Kaposi's/COMPLICATIONS/*RADIOGRAPHY ; Tomography, X-Ray Computed SO - AJR 1986 Nov;147(5):919-22 19 UI - 87018875 AU - Abrams DI ; Volberding PA TI - Alpha interferon therapy of AIDS-associated Kaposi's sarcoma. AB - Alpha interferon has been the most widely studied biologic response modifier for the treatment of Kaposi's sarcoma (KS) associated with acquired immune deficiency syndrome (AIDS). At San Francisco General Hospital's AIDS Clinic, three sequential trials of recombinant interferon alfa-2b (Intron A) were conducted between August 1982 and April 1984. In the first study, ten patients with early KS were randomized to receive either low-dose (1 MU/m2) subcutaneous (SC) or high-dose (50 MU/m2) intravenous (IV) treatment 5 days per week, every other week, for eight weeks. A perceived advantage of the latter regimen led to a subsequent trial in which 20 subjects received high-dose IV therapy. A 32% objective response rate was achieved, despite the fact that these patients had less favorable disease status and more constitutional symptoms than those in the first trial and had also experienced previous opportunistic infections (OIs). A final 8-week investigation evaluated the use of 30 MU/m2 three times per week in 30 subjects. Drug-related toxicity seemed more pronounced with this regimen, but overall objective responses were identical to those seen in the high-dose IV study. None of the trials produced evidence of immune reconstitution on laboratory evaluation. The patients were not protected from developing AIDS-related OI either during or following interferon therapy, although OI was diagnosed less frequently in responders, who also displayed a distinct survival advantage over those with progressive disease. These trends remained evident when the data from the three studies were pooled with those from three parallel trials conducted at the University of California, Los Angeles (UCLA). Studies evaluating the combined use of alpha interferon and chemotherapeutic agents known to be active against AIDS-related KS (such as VP-16 and vinblastine) have thus far failed to demonstrate a synergistic antitumor effect, while toxicity has increased. In light of in vitro evidence that alpha interferon suppresses the AIDS retrovirus and has clinical efficacy in KS comparable to that of cytotoxic agents, additional investigations, focusing on maximizing therapeutic potential, are warranted. MH - Acquired Immunodeficiency Syndrome/*THERAPY ; Antineoplastic Agents, Combined/THERAPEUTIC USE ; Clinical Trials ; Human ; Interferon Type I/ADVERSE EFFECTS/*THERAPEUTIC USE ; Opportunistic Infections/PREVENTION & CONTROL ; Recombinant Proteins/ADVERSE EFFECTS/THERAPEUTIC USE ; Sarcoma, Kaposi's/ *THERAPY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Semin Oncol 1986 Sep;13(3 Suppl 2):43-7 20 UI - 87018754 AU - Cottier H ; Hess MW ; W:alti ER TI - Immunodeficiency and cancer: mechanisms involved. AB - This is a short overview concerning possible relationships between immunodeficiency and cancerogenesis/leukemogenesis. Following introductory remarks on concomitant and sinecomitant antitumor immunity, various factors/mechanisms that could influence tumor-host-interactions are discussed, in particular properties of neoplastic cell lines, the microenvironment, cellular components of nonspecific resistance, and specific, i.e. antigen-directed, cell-mediated and humoral immune responses against cancer cells. The increased incidence of malignant neoplastic processes in patients with inherited or acquired immunodeficiency raises the question if a lack of antitumoral defense or ineffective antiviral immunity is more important. Available data indicate that once a cancer has reached a certain size, the chances for the host to reject it solely with the help of its immune apparatus are minimal. The possibility remains that immune reactions may be more efficacious against small numbers of immunogenic tumor cells, i.e. in the very earliest phase of a neoplastic process and when the cancer begins to metastasize. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Antibodies, Neoplasm/IMMUNOLOGY ; Antibody Formation ; Antigens, Neoplasm/ IMMUNOLOGY ; Human ; Immunity, Cellular ; Immunologic Deficiency Syndromes/*COMPLICATIONS ; Leukemia/ETIOLOGY/IMMUNOLOGY ; Lymphoma/ETIOLOGY/IMMUNOLOGY ; Neoplasm Metastasis/IMMUNOLOGY ; Neoplasms/*ETIOLOGY/IMMUNOLOGY ; Review SO - Schweiz Med Wochenschr 1986 Aug 23;116(34):1119-26 21 UI - 87013479 AU - Frazer IH ; Medley G ; Crapper RM ; Brown TC ; Mackay IR TI - Association between anorectal dysplasia, human papillomavirus, and human immunodeficiency virus infection in homosexual men. AB - Cells from the anorectal mucosa of 61 homosexual men were examined microscopically for evidence of papillomavirus infection and dysplastic changes. There was cytological evidence of dysplasia with concomitant features of human papillomavirus (HPV) infection on at least one occasion in 24 men and of papillomavirus infection without dysplasia on at least one occasion in a further 26: dysplasia was present for over one year in 9 of 14 men who were re-examined. Dysplasia was associated with a history of anal warts, frequent receptive anal intercourse, presence of serum antibody to human immunodeficiency virus (HIV), and immune dysfunction as judged by a low CD4/CD8 ratio, but not with the lifetime number of sexual partners. The association of longlasting dysplasia with anti-HIV was independent of the association with immune dysfunction. Thus infection of anorectal mucosal cells with papillomavirus seems to be frequent among homosexual men and may predispose to dysplasia. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Antibodies, Viral/ANALYSIS ; Anus/*PATHOLOGY ; *Homosexuality ; Human ; Immune Tolerance ; Intestinal Mucosa/PATHOLOGY ; Lymphocytes/ CLASSIFICATION ; Male ; Papillomaviruses ; Prospective Studies ; Rectum/*PATHOLOGY ; Risk ; Sex Behavior ; Support, Non-U.S. Gov't ; Tumor Virus Infections/*COMPLICATIONS ; Warts/PATHOLOGY SO - Lancet 1986 Sep 20;2(8508):657-60 22 UI - 87003636 AU - Zibrak JD ; Silvestri RC ; Costello P ; Marlink R ; Jensen WA ; Robins A ; Rose RM TI - Bronchoscopic and radiologic features of Kaposi's sarcoma involving the respiratory system. AB - In a group of 61 patients admitted to New England Deaconess Hospital, Boston, with a diagnosis of acquired immune deficiency syndrome (AIDS), 25 were found to have Kaposi's sarcoma involving the skin and mucous membranes. Of these 25 patients, eight had lesions involving the respiratory system. Radiographically, patients with Kaposi's sarcoma had hilar and mediastinal adenopathy with perihilar parenchymal infiltration which progressed to diffuse bilateral infiltrates over a period of months. This pattern and the tempo of its evolution were distinctly different from the diffuse infiltrates seen in patients with Pneumocystis carinii pneumonia. Bronchoscopy was performed in seven of the eight patients, revealing characteristic lesions of Kaposi's sarcoma in the airways. We propose that parenchymal pulmonary Kaposi's sarcoma can be strongly suspected in a patient with AIDS who has the following features: a characteristic radiologic pattern; endobronchial Kaposi's sarcoma at bronchoscopy; and no evidence of opportunistic infection. In this subset of patients, further diagnostic intervention such as open lung biopsy, a procedure with potential morbidity in these ill individuals, may be unnecessary. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Bronchoscopy ; Diagnosis, Differential ; Human ; Opportunistic Infections/ DIAGNOSIS ; Pneumonia, Pneumocystis Carinii/DIAGNOSIS ; Respiratory Tract Neoplasms/*DIAGNOSIS/PATHOLOGY/RADIOGRAPHY ; Sarcoma, Kaposi's/*DIAGNOSIS/PATHOLOGY/RADIOGRAPHY SO - Chest 1986 Oct;90(4):476-9 23 UI - 87000012 AU - Reiss RF ; Rubinstein P ; Friedman-Kien A ; Laubenstein LJ ; Ciavarella D ; Smith J ; Walker M TI - Partial plasma exchange in patients with AIDS and Kaposi's sarcoma. Plasmapheresis in AIDS. AB - Intensive plasma exchange was performed in seven male homosexual patients with AIDS and Kaposi's sarcoma. Serial 1.2 plasma volume exchange procedures were performed three times a week for six weeks. In five of the patients, plasma replacement included gamma globulin in the form of plasma (two patients), or an IV IgG preparation (three patients). No changes in the mean number of helper-inducer or suppressor-cytotoxic cells were noted during the treatment period or the weeks following completion of the last procedure. The mean mitogenic response of the patients' lymphocytes to PHA increased by 32.4% during the course of the plasmapheresis procedures (p less than .05), but returned to baseline over the eight weeks following treatment. Mitogenic responsiveness to PWM did not significantly increase during the course of treatment. No regression of Kaposi's sarcoma lesions was found in any of the patients treated. MH - Acquired Immunodeficiency Syndrome/*THERAPY ; Gamma Globulins/ ANALYSIS ; Helper Cells/IMMUNOLOGY ; Homosexuality ; Human ; Male ; *Plasma Exchange ; *Plasmapheresis ; Sarcoma, Kaposi's/*THERAPY ; Support, Non-U.S. Gov't ; Suppressor Cells/IMMUNOLOGY SO - AIDS Res 1986 Summer;2(3):183-90 24 UI - 86294297 AU - Rosenberg NL ; Hochberg FH ; Miller G ; Kleinschmidt-DeMasters BK TI - Primary central nervous system lymphoma related to Epstein-Barr virus in a patient with acquired immune deficiency syndrome. AB - The study of a patient suggested a relationship between Epstein-Barr virus infection and primary lymphoma of the central nervous system in the acquired immune deficiency syndrome. Deoxyribonucleic acid preparations from tumor tissue contained 30 to 100 copies of Epstein-Barr virus genome per cell when hybridized with a probe consisting of the Bam-HI K fragment of Epstein-Barr virus strain FF41. This hybridization study suggests that induction of this patient's central nervous system lymphoma was related to Epstein-Barr virus infection. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Brain Neoplasms/ANALYSIS/*COMPLICATIONS ; Case Report ; DNA, Viral/ ANALYSIS ; Epstein-Barr Virus ; Human ; Lymphoma, Non-Hodgkin's/ ANALYSIS/*COMPLICATIONS ; Male ; Middle Age ; *Occipital Lobe ; Tumor Virus Infections/*COMPLICATIONS SO - Ann Neurol 1986 Jul;20(1):98-102 25 UI - 86255621 AU - Collier PE TI - Small bowel lymphoma associated with AIDS. AB - Patients with the Acquired Immunodeficiency Syndrome (AIDS) are known to be at increased risk for developing malignancy; however, the spectrum that these malignancies encompass has not been fully defined. An unusual case of a 32 year old homosexual male with AIDS who developed two spontaneous small bowel perforations is presented. The diagnosis of primary histiocytic lymphoma of the small intestine was established only after his second operation. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Case Report ; Human ; Ileal Neoplasms/*COMPLICATIONS/PATHOLOGY ; Lymphoma, Histiocytic/*COMPLICATIONS/PATHOLOGY ; Male SO - J Surg Oncol 1986 Jun;32(2):131-3 26 UI - 86219656 AU - Lee MH ; Waxman M ; Gillooley JF TI - Primary malignant lymphoma of the anorectum in homosexual men. AB - Two homosexual men presented with primary malignant lymphomas of the anorectum. Each patient presented with a painful mass, diagnosed by biopsy and immunologic cell marker studies. One patient, who had a reversed T4/T8 cell ratio, developed a local relapse of the tumor 11 months after radiotherapy, and Pneumocystis carinii pneumonia. The other patient, with a normal T4/T8 ratio, remained lymphoma-free and without evidence of opportunistic infection 25 months after combined chemotherapy and radiotherapy. Anorectal pathologic findings in homosexual men includes proctitis, inflammatory stricture, fissure, or anal warts. Malignant anorectal diseases, such as Kaposi's sarcoma, and cloacogenic or squamous cell carcinomas have been described in homosexual men. Primary malignant lymphoma of the anorectum is rare in both the homosexual and general populations. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Anus Neoplasms/ETIOLOGY/*PATHOLOGY ; Burkitt's Lymphoma/PATHOLOGY ; Case Report ; *Homosexuality ; Human ; Intestinal Mucosa/ PATHOLOGY ; Lymphoma/ETIOLOGY/*PATHOLOGY ; Lymphoma, Non-Hodgkin's/PATHOLOGY ; Male SO - Dis Colon Rectum 1986 Jun;29(6):413-6 27 UI - 86214456 AU - Caccamo D ; Pervez NK ; Marchevsky A TI - Primary lymphoma of the liver in the acquired immunodeficiency syndrome. AB - We describe a 78-year-old man with a diffuse large-cell lymphoma that was limited to the liver and was associated with micronodular cirrhosis and Kaposi's sarcoma that involved abdominal lymph nodes and gastric mucosa. The serum of the patient reacted positively to a test for human T-cell lymphotropic virus type III antibodies. We discuss the clinical and autopsy findings for this unusual patient, the criteria for the diagnosis of primary lymphoma of the liver, and its occurrence in patients with the acquired immunodeficiency syndrome. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DIAGNOSIS/ PATHOLOGY ; Aged ; Antibodies, Viral/ANALYSIS ; Bone Marrow/ PATHOLOGY ; Case Report ; Human ; Human T-Cell Leukemia Virus/ IMMUNOLOGY ; Liver/PATHOLOGY ; Liver Neoplasms/*ETIOLOGY/ PATHOLOGY ; Lymph Nodes/PATHOLOGY ; Lymphoma/*ETIOLOGY/PATHOLOGY ; Male ; Sarcoma, Kaposi's/ETIOLOGY/PATHOLOGY SO - Arch Pathol Lab Med 1986 Jun;110(6):553-5 28 UI - 86185858 AU - Burkes RL ; Meyer PR ; Gill PS ; Parker JW ; Rasheed S ; Levine AM TI - Rectal lymphoma in homosexual men. AB - Lymphoma of the rectum is a rare tumor and in most studies is not separated from other lymphomas of the large intestine. We have recently examined four homosexual men with lymphoma presenting in the rectum. Symptoms included rectal bleeding in three, pain on defecation in two, and mucoid rectal discharge in two. Systemic "B: symptoms (ie, fever, night sweats, and/or weight loss), as well as a rectal mass, were present in all four. All were high-grade tumors, with B-cell immunoblastic sarcoma in two and small noncleaved Burkitt-like lymphoma in two. Intracytoplasmic immunoperoxidase staining revealed monoclonal kappa light chains in three tumors, whereas the fourth was nonstaining. Immunologic abnormalities were similar to those reported in patients with acquired immunodeficiency syndrome. Antibodies to human T-cell lymphotropic virus type III were found in the three cases tested, and retrovirus was cultured from lymphomatous tissue in one. Despite multiagent chemotherapy, two patients died within six months of diagnosis and a third has recently suffered relapse within the central nervous system. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/DIAGNOSIS ; Adult ; Antibodies, Viral/ANALYSIS ; Burkitt's Lymphoma/ETIOLOGY ; Case Report ; *Homosexuality ; Human ; Lymphoma/*ETIOLOGY ; Lymphoma, Non-Hodgkin's/ETIOLOGY ; Male ; Middle Age ; Rectal Neoplasms/*ETIOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Arch Intern Med 1986 May;146(5):913-5 29 UI - 86179894 AU - Waldmann TA TI - The structure, function, and expression of interleukin-2 receptors on normal and malignant lymphocytes. AB - Antigen or mitogen-induced activation of resting T cells induces the synthesis of interleukin-2 (IL-2) as well as the expression of specific cell surface receptors for this lymphokine. Failure of the production of either IL-2 or its receptor results in a failure of the T-cell immune response. The receptor is composed of a 33,000-dalton (251-amino acid) peptide precursor that is post-translationally glycosylated into the mature 55,000-dalton form. In contrast to resting T cells, human T-cell lymphotrophic virus I (HTLV-I)-associated adult T-cell leukemia cells constitutively express large numbers of IL-2 receptors. Because IL-2 receptors are present on the malignant T cells but not on normal resting cells, clinical trials have been initiated in which patients with adult T-cell leukemia are treated with a monoclonal antibody that binds to the IL-2 receptor. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY ; Animal ; Antibodies, Monoclonal/THERAPEUTIC USE ; B Lymphocytes/PHYSIOLOGY ; Clinical Trials ; Cloning, Molecular ; DNA/GENETICS ; Gene Expression Regulation ; Human ; Human T-Cell Leukemia Virus/ PHYSIOLOGY ; Interleukin 2/PHYSIOLOGY ; Leukemia/*IMMUNOLOGY/ THERAPY ; Lymphocytes/MICROBIOLOGY/*PHYSIOLOGY ; Mice/IMMUNOLOGY ; Receptors, Immunologic/GENETICS/ISOLATION & PURIFICATION/ *PHYSIOLOGY ; T Lymphocytes/PHYSIOLOGY SO - Science 1986 May 9;232(4751):727-32 30 UI - 86133132 AU - Braun DP ; Harris JE TI - Abnormal monocyte function in patients with Kaposi's sarcoma. AB - Monocyte-mediated functions were evaluated in the peripheral blood mononuclear cells (PBMC) of 11 previously untreated patients with Kaposi's sarcoma in association with the acquired immune deficiency syndrome (KS/AIDS). All patients had lymphadenopathy, an abnormal OKT.4/OKT.8 ratio, and a good performance status; none had clinically apparent infections at the time of testing. Monocyte functional assessments included immunoregulatory activity in phytohemagglutinin-stimulated (PHA) lymphoblastogenesis assays, natural killer (NK) assays, Interleukin 2 (IL2) production assays and, quantitation of opsonized zymosan-induced chemiluminescence responses. A group of seven hemophilia patients who had been receiving concentrated blood products and who presented with evidence of an abnormal OKT.4/OKT.8 ratio were also investigated as controls. As a group, the patients with KS/AIDS had a significantly depressed response to PHA compared with normal control subjects and patients with hemophilia; this was significantly elevated by indomethacin or by the removal of glass adherent cells. PBMC from KS/AIDS patients also had an impaired ability to produce IL2 in PHA-stimulated cultures which was enhanced by the addition of indomethacin. NK function was also suppressed in both groups of patients, but could not be augmented by the removal of glass adherent monocytes. Chemiluminescence responses to opsonized zymosan were variable, but found to be significantly different from normal in the majority of patients studied. These results demonstrate that monocyte function can be abnormal in patients with KS/AIDS and might contribute to some of the immunologic impairment seen in these patients. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY ; Adolescence ; Adult ; Cells, Cultured ; Comparative Study ; Disease Susceptibility ; DNA, Neoplasm/BIOSYNTHESIS ; Hemophilia/ IMMUNOLOGY ; Human ; Indomethacin/PHARMACODYNAMICS ; Interleukin 2/PHARMACODYNAMICS ; Killer Cells, Natural/DRUG EFFECTS ; Luminescence ; Lymphocyte Depletion ; Lymphocytes/CLASSIFICATION/ DRUG EFFECTS/*IMMUNOLOGY ; Monocytes/*IMMUNOLOGY ; Phytohemagglutinins/PHARMACODYNAMICS ; Sarcoma, Kaposi's/ COMPLICATIONS/*IMMUNOLOGY ; Zymosan/PHARMACODYNAMICS SO - Cancer 1986 Apr 15;57(8):1501-6 31 UI - 86319782 AU - Lee YY ; Bruner JM ; Van Tassel P ; Libshitz HI TI - Primary central nervous system lymphoma: CT and pathologic correlation. AB - CT findings of 15 patients with histologically proven primary central nervous system (CNS) lymphoma were reviewed with pathologic correlation in order to evaluate variable CT patterns. There were a total of 32 lesions. Of the 15 patients studied, seven had acquired immunodeficiency syndrome (AIDS), all diagnosed within the past 3 years. The CT observations of eight non-AIDS patients were consistent with findings reported previously. Most of the lymphomatous lesions were either hyper- or isodense, round or oval masses with homogeneous contrast enhancement and variable surrounding edema. Pathologic examination showed tightly packed preserved lymphoma cells without necrosis. In AIDS patients, rim or ring enhancement of lymphoma, indistinguishable from brain abscess, was frequently seen. Histologic examination consistently showed extensive tumor necrosis with preservation of viable tumor cells at the periphery. A third and infrequent CT pattern was multiple infiltrative nonnodular solid enhancement with extensive edema. Pathologic correlation showed infiltrating viable tumor cells without necrosis. The rim- or ring-enhancing brain lesion seen in AIDS patients can either be an abscess or a primary lymphoma; proper tissue collection is essential for correct diagnosis and appropriate treatment. MH - Acquired Immunodeficiency Syndrome/PATHOLOGY/RADIOGRAPHY ; Adolescence ; Adult ; Aged ; Brain Neoplasms/PATHOLOGY/ *RADIOGRAPHY ; Child ; Female ; Human ; Lymphoma/PATHOLOGY/ *RADIOGRAPHY ; Male ; Middle Age ; Tomography, X-Ray Computed SO - AJR 1986 Oct;147(4):747-52 32 UI - 86312231 AU - Ganser A ; Br:ucher W ; Brodt HR ; Busch W ; Brandhorst I ; Helm EB ; Hoelzer D TI - Treatment of AIDS-related Kaposi's sarcoma with recombinant gamma-interferon. AB - Four patients with the acquired immunodeficiency syndrome and Kaposi's sarcoma were treated with subcutaneous human recombinant gamma-interferon at a dosage of 200 micrograms = 2 X 10(6) U twice daily for at least 28 days. While the dosage of interferon was well tolerated, progressive disease was observed in all four patients studied. These results might be due to the selection of the patients presenting advanced stages (3 out of 4) with recurrent disease after previous chemotherapy. MH - Acquired Immunodeficiency Syndrome/*THERAPY ; Adult ; Female ; Follow-Up Studies ; Human ; Human T-Cell Leukemia Virus ; Interferon Type II/*THERAPEUTIC USE ; Male ; Middle Age ; Recombinant Proteins/*THERAPEUTIC USE ; Retrovirus Infections/ *THERAPY ; Sarcoma, Kaposi's/*THERAPY ; Skin Neoplasms/*THERAPY SO - Onkologie 1986 Jun;9(3):163-6 33 UI - 86298195 AU - Kaplan L ; Abrams D ; Volberding P TI - Treatment of Kaposi's sarcoma in acquired immunodeficiency syndrome with an alternating vincristine-vinblastine regimen. AB - Twenty-four patients with acquired immunodeficiency syndrome and Kaposi's sarcoma (KS) were treated with a regimen alternating vincristine with vinblastine on a weekly basis. Objective responses to this regimen were observed in nine patients (45%), and seven (35%) had stabilization of progressive KS. Few toxic effects were observed. Alternating vincristine-vinblastine therapy is well-tolerated and effective palliative treatment for KS in acquired immunodeficiency syndrome. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Drug Administration Schedule ; Homosexuality ; Human ; Male ; Middle Age ; Sarcoma, Kaposi's/*DRUG THERAPY/ETIOLOGY ; Vinblastine/ ADMINISTRATION & DOSAGE/*THERAPEUTIC USE ; Vincristine/ ADMINISTRATION & DOSAGE/*THERAPEUTIC USE SO - Cancer Treat Rep 1986 Sep;70(9):1121-2 34 UI - 86298127 AU - Blayney DW ; Ito JI ; Jensen FC TI - Spontaneous remission of Kaposi's sarcoma in an HTLV-III-negative homosexual man. AB - Kaposi's sarcoma (KS) in homosexual men has been linked to the acquired immune deficiency syndrome (AIDS). We describe a 51-year-old homosexual man who developed extremity KS while taking corticosteroids. The KS resolved when the steroids were withdrawn. He did not have classically defined AIDS: no evidence of HTLV-III infection was found after serial ELISA and "western blot: analysis of the patient's serum nor after co-cultivation of his peripheral blood lymphocytes. This clinical observation is consistent with the hypothesis that AIDS and KS may have different etiologic agents. Corticosteroids should be used with caution in patients at risk for KS (including homosexual men) and may be complicated by the development of KS without HTLV-III-induced immunosuppression. MH - Acquired Immunodeficiency Syndrome/*ETIOLOGY ; Antibodies, Viral/ *ANALYSIS ; Case Report ; *Homosexuality ; Human ; Human T-Cell Leukemia Virus/*IMMUNOLOGY ; Male ; Middle Age ; Remission, Spontaneous ; Sarcoma, Kaposi's/*ETIOLOGY ; Support, Non-U.S. Gov't SO - Cancer 1986 Oct 1;58(7):1583-4 35 UI - 86291897 AU - Konrad K ; Schenk P ; Rappersberger K TI - Tubuloreticular structures in Kaposi's sarcoma: a comparison of the classical and AIDS-associated forms. AB - The ultrastructural morphology of both the classical and the AIDS-associated forms of Kaposi's sarcoma was examined electron-microscopically. Tubuloreticular structures were found only in the AIDS-associated form of Kaposi's sarcoma, and not in the classical variant of the tumor. Moreover, the tubuloreticular structures, 20-30 nm in diameter, were present in very high numbers and in two different forms: the loosely intertwined tubuli, which were clearly predominant; and those forming a more compact pattern. These findings suggest that the presence of tubuloreticular structures may well be an ultrastructural marker for diagnosing AIDS and AIDS-associated disorders. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PATHOLOGY ; Comparative Study ; Endoplasmic Reticulum/PATHOLOGY/ *ULTRASTRUCTURE ; Human ; Sarcoma, Kaposi's/ETIOLOGY/PATHOLOGY/ *ULTRASTRUCTURE SO - Acta Derm Venereol (Stockh) 1986;66(3):207-12 36 UI - 86289479 AU - Groopman JE TI - Therapy of epidemic Kaposi's sarcoma. AB - Epidemic Kaposi's sarcoma, a neoplasm associated with AIDS, is rapidly becoming common in the United States and Europe. The pathogenesis of this form of Kaposi's sarcoma has not yet been fully understood, but epidemiological clues point to the possibility that an infectious agent (in addition to the AIDS virus HTLV-III) or an environmental toxin may be involved. The natural history and clinical course of epidemic Kaposi's sarcoma is variable. The life expectancy of an AIDS patient with Kaposi's sarcoma is probably related to his underlying immunologic status as evidenced by propensity to develop life-threatening opportunistic infections. Patients with this neoplasm should be entered on experimental treatment programs when possible in order to improve our knowledge about rational management of this disease. Recombinant interferon alfa-2a, single agent chemotherapy, and radiation all have roles in the management of the disease. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Clinical Trials ; Doxorubicin/THERAPEUTIC USE ; Human ; Interferon Type I/ THERAPEUTIC USE ; Interferon Type II/THERAPEUTIC USE ; Male ; Radiotherapy Dosage ; Recombinant Proteins/THERAPEUTIC USE ; Sarcoma, Kaposi's/DIAGNOSIS/ETIOLOGY/*THERAPY ; Skin Neoplasms/ DIAGNOSIS/ETIOLOGY/*THERAPY SO - Semin Hematol 1986 Jul;23(3 Suppl 1):14-9 37 UI - 86285825 AU - Fraser AG ; Henley JW ; Ellis-Pegler RB ; Benjamin CS ; Childs WJ ; Harvey VJ TI - The acquired immunodeficiency syndrome in Auckland in 1985. AB - We reviewed the notes of the first 11 patients with AIDS managed by the infectious disease unit, Auckland Hospital, who all presented during 1985. All were homosexual males: none had other recognised risk factors: ten had travelled beyond New Zealand. Five were diagnosed at Auckland Hospital, six overseas. Median age was 31 (range 28-43) years. Five had Kaposi's sarcoma and three Pneumocystis carinii pneumonia. Five are alive. They have spent a median 13 (range 0-41) days in Auckland Hospital. Treatment options for the more common problems are discussed. We have tended towards conservative treatment of tumour but more aggressive treatment of opportunistic infection. Medical, nursing and ancillary hospital staff and lay people involved have rapidly adapted to caring for these patients without excessive anxiety. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/OCCURRENCE/ THERAPY ; Adult ; Antibiotics/THERAPEUTIC USE ; Case Report ; Homosexuality ; Human ; Male ; New Zealand ; Pneumonia, Pneumocystis Carinii/*COMPLICATIONS ; Sarcoma, Kaposi's/ *COMPLICATIONS SO - NZ Med J 1986 Jul 9;99(805):485-8 38 UI - 86281986 AU - Seftel AD ; Sadick NS ; Waldbaum RS TI - Kaposi's sarcoma of the penis in a patient with the acquired immune deficiency syndrome. AB - We report a case of secondary Kaposi's sarcoma of the penis and the acquired immune deficiency syndrome. Recognition of the penile lesion as being secondary Kaposi's sarcoma is paramount, since the clinical course appears to be dependent upon systemic disease. Local therapy is reserved for palliation upon disease recurrence. MH - *Acquired Immunodeficiency Syndrome ; Case Report ; Human ; Male ; Middle Age ; Neoplasm Recurrence, Local ; Penile Neoplasms/ *SECONDARY ; Sarcoma, Kaposi's/*SECONDARY ; Stomach Neoplasms SO - J Urol 1986 Sep;136(3):673-5 39 UI - 86279121 AU - De Maubeuge J ; Ledoux M ; Feremans W ; Zissis G ; Goens J ; Andre J ; Gourdain JM ; Menu R ; De Wit S ; Cran S ; et al TI - Oral "hairy: leucoplakia in an African AIDS patient. AB - A 34-year-old African patient with AIDS developed a new form of oral leucoplakia closely resembling the "hairy: leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes-like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Burundi ; Case Report ; Human ; Inclusion Bodies, Viral/ ULTRASTRUCTURE ; Leukoplakia, Oral/*COMPLICATIONS/MICROBIOLOGY/ PATHOLOGY ; Male ; Microscopy, Electron ; Tongue Neoplasms/ COMPLICATIONS/MICROBIOLOGY/PATHOLOGY SO - J Cutan Pathol 1986 Jun;13(3):235-41 40 UI - 86278906 AU - Jones RR ; Spaull J ; Spry C ; Jones EW TI - Histogenesis of Kaposi's sarcoma in patients with and without acquired immune deficiency syndrome (AIDS). AB - Immunohistochemical studies were performed in thirty skin biopsies from patients with Kaposi's sarcoma, who did and did not have the acquired immune deficiency syndrome (AIDS). Tumour histogenesis was rigorously tested using a battery of endothelial cell markers, which included two new monoclonal antibodies, EN4 and PAL E. These are both specific for endothelial cells and can be visualised in appropriately fixed paraffin embedded tissue. Whereas EN4 labels all endothelial cells, PAL E is negative in endothelium of lymphatic derivation. Lectin binding with Ulex europaeus agglutinin 1 (UEA-1) and the presence of factor VIII related antigen (FVIIIRA) and laminin were also examined. In nodular lesions of Kaposi's sarcoma the spindle cell areas were positive with EN4 and UEA-1, negative with PAL E, and showed focal staining for FVIIIRA and laminin. These results confirm that the tumour is of endothelial cell origin. Six patch stage lesions showed a network of angulated spaces, lined by cells that were positive with EN4 and UEA-1, negative with PAL E and anti-FVIIIRA, and showed only weak staining for laminin. This pattern was observed in both AIDS and non-AIDS related cases and strongly favours a lymphatic derivation for the tumour. This has important implications as it suggests that lymphatic endothelium may have special characteristics that lead to neoplastic transformation in patients with retrovirus infection. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Antibodies, Monoclonal/DIAGNOSTIC USE ; Antigens/METABOLISM ; Endothelium/PATHOLOGY ; Factor VIII/IMMUNOLOGY/METABOLISM ; Human ; Laminin/METABOLISM ; Sarcoma, Kaposi's/COMPLICATIONS/METABOLISM/ *PATHOLOGY ; Skin/PATHOLOGY ; Von Willebrand Factor/METABOLISM SO - J Clin Pathol 1986 Jul;39(7):742-9 41 UI - 86276104 AU - Cantwell AR Jr TI - Mycobacterium avium-intracellulare infection and immunoblastic sarcoma in a fatal case of AIDS. AB - A pleomorphic bacterium exhibiting both acid-fast rod forms and non-acid-fast coccal forms, and identified as Mycobacterium avium-intracellulare was cultured from a facial lesion diagnosed as immunoblastic sarcoma. The patient was a 36 year-old homosexual man who died of the acquired immune deficiency syndrome (AIDS). In addition, the patient had pre-existing cutaneous lesions of Kaposi's sarcoma (KS), and was treated for probable but never proven, Pneumocystis carinii pneumonia (PCP). Variably acid-fast coccoid forms, and extremely rare acid-fast rods were demonstrated within the microscopic sections of the immunoblastic sarcoma. Similar-staining coccoid forms were also observed within the microscopic sections of the pre-existing KS tumors, and within the lung biopsy material showing inflammation suggestive of PCP. These findings, along with previously reported findings of similar bacterial forms in vivo in other cases of KS and AIDS, again suggest that variably acid-fast bacteria may play a role in the development of malignant tumors and inflammatory lung disease, which frequently occur in homosexual men with AIDS. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/MORTALITY ; Adult ; Case Report ; Homosexuality ; Human ; Lymphoma/ *COMPLICATIONS ; Male ; Mycobacterium avium ; Sarcoma, Kaposi's/ *COMPLICATIONS/PATHOLOGY ; Skin Neoplasms/*COMPLICATIONS/ PATHOLOGY ; Tuberculosis/*COMPLICATIONS SO - Growth 1986 Spring;50(1):32-40 42 UI - 86273512 AU - Balasubramanyam A ; Waxman M ; Kazal HL ; Lee MH TI - Malignant lymphoma of the heart in acquired immune deficiency syndrome. AB - Malignant lymphoma of the heart was found at autopsy of two homosexual men with acquired immune deficiency syndrome (AIDS). Both patients had symptoms and signs of cardiac dysfunction, and it is likely that the immediate cause of their deaths was related to the cardiac tumors. In both cases, there was lymphomatous involvement of other organs, but the heart was the predominant site of disease. There was prominent endocardial and myocardial involvement, and both tumors were high grade large cell lymphomas with plasmacytoid features. In both instances, the lymphomas were diagnosed only at the autopsy, despite extensive antemortem cardiac evaluation in one patient. The clinicopathologic correlation, gross pathologic and histologic findings of the tumor, and their pattern and distribution suggest a de novo origin of the lymphoma in the heart in these two patients. Lymphomatous infiltration of the heart should be suspected in patients with AIDS who have cardiac symptoms. MH - Acquired Immunodeficiency Syndrome/*PATHOLOGY ; Case Report ; Endocardium/PATHOLOGY ; Heart Neoplasms/*PATHOLOGY ; Homosexuality ; Human ; Lymphoma/*PATHOLOGY ; Male ; Middle Age ; Myocardium/*PATHOLOGY SO - Chest 1986 Aug;90(2):243-6 43 UI - 86271563 AU - Freeman CR ; Shustik C ; Brisson ML ; Meagher-Villemure K ; Dylewski I TI - Primary malignant lymphoma of the central nervous system. AB - Between 1960 and 1983, 19 patients with primary malignant lymphoma of the central nervous system (CNS) were seen at McGill University Hospitals. The diagnosis was made at autopsy in 3 patients, and by biopsy in 16. Results of treatment were poor. All four patient who underwent surgery alone died within 2 months of diagnosis. Of 12 patients who underwent surgery and postoperative radiotherapy, 11 died between 2 and 56 months (median, 12 months) following diagnosis, and one is alive with disease at 47 months. Patterns of involvement at first recurrence and/or at autopsy were analyzed for 13 patients. Failure at the original site of involvement was unusual after treatment consisting of surgery and radiotherapy. In contrast, failure in the brain at sites other than those originally involved was common in spite of the use of whole brain irradiation. Local leptomeningeal involvement was seen in one patient whose diagnosis was made at autopsy, and cerebral spinal fluid seeding was seen in two additional patients, one within 1 month of diagnosis and one at relapse at 6 months after diagnosis. No patient developed disease outside the CNS. The limitations of current therapy for this disease are discussed, and certain suggestions made regarding the management of future patients with this diagnosis. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Aged ; Alcoholism/COMPLICATIONS ; Antineoplastic Agents, Combined/ THERAPEUTIC USE ; Combined Modality Therapy ; Female ; Human ; Immunoenzyme Technics ; Immunoglobulins, Kappa Chain/ANALYSIS ; Immunoglobulins, Lambda Chain/ANALYSIS ; Lymphoma/COMPLICATIONS/ MORTALITY/*SURGERY ; Male ; Middle Age ; Neoplasm Recurrence, Local ; Neoplasm Seeding ; Nervous System Neoplasms/COMPLICATIONS/ MORTALITY/*SURGERY ; Quebec ; Radiotherapy Dosage ; Registries ; Substance Abuse SO - Cancer 1986 Sep 1;58(5):1106-11 44 UI - 86265732 AU - Meduri GU ; Stover DE ; Lee M ; Myskowski PL ; Caravelli JF ; Zaman MB TI - Pulmonary Kaposi's sarcoma in the acquired immune deficiency syndrome. Clinical, radiographic, and pathologic manifestations. AB - Pulmonary Kaposi's sarcoma related to the acquired immune deficiency syndrome (AIDS) has not been well characterized. To define the clinical, radiographic, and pathologic features of this entity, 11 autopsy-proved cases of pulmonary Kaposi's sarcoma were reviewed. The most common clinical symptoms were dyspnea and cough, but hemoptysis and stridor were also found. Nodular infiltrates and pleural effusions were the most commonly found radiographic abnormalities. Pulmonary function tests were sensitive in detecting the pulmonary abnormalities due to Kaposi's sarcoma. A low diffusion capacity, lack of arterial desaturation with exercise, and obstruction to airflow were suggestive of pulmonary involvement with this malignancy. Although endobronchial Kaposi's sarcoma was visualized at bronchoscopy as cherry-red, slightly raised lesions, bronchial biopsy specimens always showed no abnormalities. Transbronchial brushings and biopsy specimens and analysis of pleural fluid were also not helpful in establishing a diagnosis. In the seven subjects with extensive parenchymal Kaposi's sarcoma at autopsy, the pleura was always involved. Eight subjects had involvement of the tracheobronchial tree. In all of the subjects, pulmonary Kaposi's sarcoma was a significant cause of morbidity, and in three of 11 subjects (27 percent) it was the direct cause of death. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Bronchoscopy ; Human ; Lung/PATHOLOGY ; Lung Neoplasms/ COMPLICATIONS/*PATHOLOGY/PHYSIOPATHOLOGY/RADIOGRAPHY ; Male ; Middle Age ; Pulmonary Diffusing Capacity ; Respiratory Airflow ; Sarcoma, Kaposi's/COMPLICATIONS/*PATHOLOGY/PHYSIOPATHOLOGY/ RADIOGRAPHY ; Vital Capacity SO - Am J Med 1986 Jul;81(1):11-8 45 UI - 86255077 AU - Baskin GB ; Martin LN ; Rangan SR ; Gormus BJ ; Murphey-Corb M ; Wolf RH ; Soike KF TI - Transmissible lymphoma and simian acquired immunodeficiency syndrome in rhesus monkeys. AB - Four rhesus monkeys (Macaca mulatta) were inoculated with a homogenate of a cutaneous lepromatous leprosy lesion from a mangabey monkey (Cercocebus atys). One died of B-cell lymphoma, and another died of an immunodeficiency syndrome. Cell suspensions prepared from the tumor and spleen of the monkey with lymphoma induced lymphoma or an immunodeficiency syndrome when inoculated into additional young rhesus monkeys. The immunodeficiency syndrome was similar to simian acquired immunodeficiency syndrome and consisted of opportunistic infections, lymphoid hyperplasia or atrophy, wasting, and syncytial cell formation. Mitogen responses and percentages of T4- and T8-positive lymphocytes were normal until the animals were moribund. Lymphoblastoid cell lines became established in vitro from tumor cell suspensions. These cells were infected with a herpesvirus related to Epstein-Barr virus. In addition, a retrovirus morphologically similar to human T-cell lymphotrophic virus type III (HTLV-III) and simian T-lymphotrophic virus type III (STLV-III) was isolated from one of the lymphoblastoid cell lines (LCL). Type D retroviruses could not be demonstrated in the monkeys in the transmission study; however, a retrovirus similar to that in the LCL was isolated from 4 animals by coculture of peripheral blood lymphocytes with the human cell line H9. These results suggest that this retrovirus, STLV-III/Delta, may be associated with the immunodeficiency syndrome in these macaques and may be of mangabey origin. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY/MICROBIOLOGY/ *TRANSMISSION ; Animal ; Anthropoidea/MICROBIOLOGY ; Antibodies, Monoclonal ; Cell Line ; Cells, Cultured ; Cytopathogenic Effect, Viral ; DNA Restriction Enzymes ; DNA, Viral/ANALYSIS ; Epstein-Barr Virus/GENETICS ; Female ; Human T-Cell Leukemia Virus/IMMUNOLOGY ; Lymphocytes/CLASSIFICATION ; Lymphoma/ IMMUNOLOGY/PATHOLOGY/*TRANSMISSION ; Macaca mulatta ; Male ; Microscopy, Electron ; Retrovirus Infections/TRANSMISSION ; Support, U.S. Gov't, P.H.S. ; Tumor Virus Infections/ *TRANSMISSION ; Virion/ULTRASTRUCTURE SO - JNCI 1986 Jul;77(1):127-39 46 UI - 86251361 AU - Francis ND ; Parkin JM ; Weber J ; Boylston AW TI - Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS). AB - Of 22 patients with Kaposi's sarcoma, 16 had the acquired immune deficiency syndrome (AIDS). The histological pattern in AIDS differs from the more familiar classical Kaposi's sarcoma. The features most useful in making the diagnosis are: dissection of collagen; lymphatic vessel like spaces; angiomatoid lesions; premonitory sign; and spindle cell proliferation. It is important to examine multiple levels of small biopsy specimens and to be cautious in making the diagnosis of patch Kaposi's sarcoma in the presence of recent or healed ulceration and at sites of previous trauma. Only four of 16 patients with AIDS had evidence of systemic Kaposi's sarcoma, supporting the view that Kaposi's sarcoma in AIDS does not necessarily have an aggressive clinical course. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ; Aged ; Collagen ; Female ; Human ; Male ; Middle Age ; Mouth/PATHOLOGY ; Rectum/PATHOLOGY ; Sarcoma, Kaposi's/ *COMPLICATIONS/PATHOLOGY ; Skin/PATHOLOGY ; Trachea/PATHOLOGY SO - J Clin Pathol 1986 May;39(5):469-74 47 UI - 86245779 AU - Malaise MG ; Davin JC ; Mahieu PR ; Franchimont P TI - Elevated antigalactosyl antibody titers reflect renal injury after gold or D-penicillamine in rheumatoid arthritis [published erratum appears in Clin Immunol Immunopathol 1986 Nov;41(2):303] AB - Titers of circulating antigalactosyl antibodies (a-Gal Ab) were assessed by passive hemagglutination using rabbit red blood cells in 40 normal subjects, in 14 patients with immunodeficient states, in 47 patients with active rheumatoid arthritis (RA), and in 15 patients with an Henoch-Sch:onlein disease (HS). Titers of controls ranged from 1:16 to 1:64. All immunodeficient patients exhibited very low titers (1:1). On the contrary, the existence of an enhanced humoral immune response status, as observed in RA, was not reflected by a parallel increase of a-Gal Ab titers. However, in this disease, a strong relationship existed between titers exceeding control values (greater than 1:64) and the prior occurrence of renal injury under gold or D-penicillamine therapy. Lastly, the discovery of elevated titers (greater than 1:64) in HS only when renal involvement occurred further suggests that such antibodies reflect a renal injury. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY ; Adolescence ; Adult ; Aged ; Antibody Formation ; Antibody Specificity ; Arthritis, Rheumatoid/DRUG THERAPY/*IMMUNOLOGY ; Child ; Child, Preschool ; Dimercaprol/*ANALOGS & DERIVATIVES/ADVERSE EFFECTS/ THERAPEUTIC USE ; Female ; Gold/*ADVERSE EFFECTS/THERAPEUTIC USE ; Hemagglutination Tests ; Human ; IgG/*ANALYSIS ; Immune Complex Disease/*CHEMICALLY INDUCED/IMMUNOLOGY ; Infant ; Kidney/ IMMUNOLOGY ; Kidney Diseases/*CHEMICALLY INDUCED/IMMUNOLOGY ; Male ; Middle Age ; Multiple Myeloma/*IMMUNOLOGY ; Penicillamine/ *ADVERSE EFFECTS/THERAPEUTIC USE ; Purpura, Schoenlein-Henoch/ DRUG THERAPY/*IMMUNOLOGY SO - Clin Immunol Immunopathol 1986 Aug;40(2):356-64 48 UI - 86244702 AU - Unger PD ; Strauchen JA TI - Hodgkin's disease in AIDS complex patients. Report of four cases and tissue immunologic marker studies. AB - Hodgkin's disease developed in four homosexual men with prodromal manifestations associated with the Acquired Immune Deficiency Syndrome (AIDS) (generalized lymphadenopathy in three and persistent diarrhea, fever, and weight loss in one). All had inversion of the peripheral blood helper-to-suppressor T-cell ratio. The presentations with Hodgkin's disease were atypical with advanced disease (Stage IIIB or IV) in three of four patients and marrow involvement at diagnosis in two. Response to therapy was poor. Immunopathologic studies on the Hodgkin's disease tissue were performed in two patients. In contrast to Hodgkin's disease in non-AIDS risk patients, the Hodgkin's disease tissue in these patients demonstrated severe depletion of helper T-lymphocytes with a predominance of suppressor cells (tissue helper-to-suppressor cell ratio of 0.19 and 0.33, respectively, on immunoperoxidase-stained preparations). In contrast, in five cases of Hodgkin's disease from non-AIDS risk individuals, the lymphocytes population consisted predominantly of helper T-lymphocytes (median tissue helper-to-suppressor cell ratio 3.15, range 2.12-7.77). Homosexual men with AIDS risk factors are at risk for the development of Hodgkin's disease. Hodgkin's disease in these patients may be atypical with severe depletion of helper T-lymphocytes and a predominance of suppressor cells. The lack of an appropriate T-cell immunologic response may contribute to the poor prognosis observed in these patients. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/IMMUNOLOGY ; Adult ; Antibodies, Monoclonal ; Bone Marrow/IMMUNOLOGY ; Case Report ; Comparative Study ; Helper Cells/IMMUNOLOGY ; Histocytochemistry ; Hodgkin's Disease/*COMPLICATIONS/IMMUNOLOGY ; Homosexuality ; Human ; Immunoenzyme Technics ; Lymph Nodes/ IMMUNOLOGY ; Male ; Prognosis ; Suppressor Cells/IMMUNOLOGY ; T Lymphocytes/CLASSIFICATION/*IMMUNOLOGY SO - Cancer 1986 Aug 15;58(4):821-5 49 UI - 86239326 AU - Little BJ ; Spivak JL ; Quinn TC ; Mann RB TI - Kaposi's sarcoma with bone marrow involvement: occurrence in a patient with the acquired immunodeficiency syndrome. AB - A patient with the acquired immune deficiency syndrome (AIDS) and the lymphadenopathic variant of Kaposi's sarcoma developed skin, gastrointestinal and pulmonary lesions. A cellular specimen was obtained on bone marrow aspiration, but the bone marrow biopsy revealed dense reticulin fibrosis with slit-like spaces and endothelial-lined channels consistent with Kaposi's sarcoma. At postmortem examination, Kaposi's sarcoma was found in the pleura and lungs, throughout the gastrointestinal tract, in the liver and spleen, and in the thoracic and abdominal lymph nodes. Bone marrow architecture appeared grossly normal, but microscopic examination revealed numerous foci of Kaposi's sarcoma. This is the first reported example of bone marrow involvement with Kaposi's sarcoma in AIDS recognized antemortem. MH - Abdominal Neoplasms/ETIOLOGY/PATHOLOGY ; Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ; Bone Marrow/*PATHOLOGY ; Case Report ; Gastrointestinal Neoplasms/ ETIOLOGY/PATHOLOGY ; Homosexuality ; Human ; Lung Neoplasms/ *ETIOLOGY/PATHOLOGY ; Lymphatic Metastasis ; Male ; Respiratory Insufficiency/ETIOLOGY ; Sarcoma, Kaposi's/*ETIOLOGY/PATHOLOGY ; Thoracic Neoplasms/ETIOLOGY/PATHOLOGY SO - Am J Med Sci 1986 Jul;292(1):44-6 50 UI - 86235991 AU - Penn I TI - Cancer is a complication of severe immunosuppression. AB - Diverse states of immunodeficiency are complicated by the development of various types of cancer. Most striking in nearly every type of immunodeficiency is a high incidence of a neoplasm of the immune system itself, the NHL, which consists of activated pathologic lymphocytes. Morphologically, these are mostly reticulum cell sarcomas, arise from B-cells, tend to be extranodal in distribution, have a predilection for the brain and are probably caused by EBV. If Kaposi's sarcoma is a form of lymphoreticular malignant disease, as some investigators think, the situation becomes even more intriguing. We need to intensively study the various groups of immunosuppressed patients, including those with and without tumors, to seek clues to the cause of neoplasms. Such information may shed light on the causes of similar malignant conditions that occur in the general population and on the role of the immune system in the control of cancer. Hopefully, such knowledge may lead to immunologic methods for the prevention and cure of neoplasms. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Antineoplastic Agents/ADVERSE EFFECTS ; Bladder Neoplasms/ ETIOLOGY ; Cervix Neoplasms/ETIOLOGY ; Female ; Human ; Immunologic Deficiency Syndromes/*COMPLICATIONS/FAMILIAL & GENETIC ; Immunosuppression/*ADVERSE EFFECTS ; Immunosuppressive Agents/ADVERSE EFFECTS ; Kidney Failure, Chronic/COMPLICATIONS ; Leukemia/ETIOLOGY ; Lip Neoplasms/ETIOLOGY ; Lymphoma/ETIOLOGY ; Neoplasms/*ETIOLOGY/IMMUNOLOGY ; Review ; Sarcoma, Kaposi's/ ETIOLOGY ; Skin Neoplasms/ETIOLOGY ; Support, U.S. Gov't, Non-P.H.S. ; *Transplantation Immunology ; Vulvar Neoplasms/ ETIOLOGY SO - Surg Gynecol Obstet 1986 Jun;162(6):603-10 51 UI - 86231951 AU - Schenk P TI - Erythrophagocytosis in Kaposi's sarcoma in acquired immune deficiency syndrome. AB - The ultrastructural morphology of Kaposi's sarcoma of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS) was examined electron-microscopically. Neoplastic spindle cells and vascular endothelial tumor cells are frequently involved in the phagocytosis of extravasated erythrocytes. Pericytes, fibroblasts, macrophages and other phagocytic cells of the tumor stroma also participate in this process. Erythrocytes are also phagocytized by some of the keratinocytes belonging to the intact surface epithelium covering the Kaposi's sarcoma lesion. Both the phenomenon of erythrophagocytosis and the presence of tubuloreticular structures in the cytoplasm of Kaposi's sarcoma cells in patients with AIDS seem to be prominent ultrastructural markers and thus of diagnostic value. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY/ PHYSIOPATHOLOGY ; Erythrocytes/ULTRASTRUCTURE ; Human ; Macrophages/PHYSIOLOGY/ULTRASTRUCTURE ; Microscopy, Electron ; *Phagocytosis ; Sarcoma, Kaposi's/PHYSIOPATHOLOGY/*ULTRASTRUCTURE SO - ORL J Otorhinolaryngol Relat Spec 1986;48(3):167-73 52 UI - 86225265 AU - Keith JE Jr ; Wilgis EF TI - Kaposi's sarcoma in the hand of an AIDS patient. AB - A case of Kaposi's sarcoma of a digit in a patient with acquired immune deficiency syndrome (AIDS) is described. The patient had what appeared to be a chronic paronychia. The paronychia tissue was excised and biopsy findings showed Kaposi's sarcoma. Kaposi's sarcoma is a multicentric, malignant, vascular tumor composed of proliferating spindle-shaped cells and capillary vessels. MH - Acquired Immunodeficiency Syndrome/*DIAGNOSIS ; Adult ; Case Report ; Chronic Disease ; Diagnosis, Differential ; *Fingers ; Human ; Male ; Paronychia/DIAGNOSIS ; Sarcoma, Kaposi's/BLOOD SUPPLY/*DIAGNOSIS/PATHOLOGY SO - J Hand Surg [Am] 1986 May;11(3):410-3 53 UI - 86212776 AU - Purdy LJ ; Colby TV ; Yousem SA ; Battifora H TI - Pulmonary Kaposi's sarcoma. Premortem histologic diagnosis. AB - Nine open lung biopsies and nine transbronchial biopsies from 10 patients with pulmonary Kaposi's sarcoma were reviewed to define the pattern of involvement in the lung by Kaposi's sarcoma and to determine the usefulness of transbronchial biopsy in making the diagnosis. There were nine patients with acquired immune deficiency syndrome (AIDS) and one patient with sporadic pulmonary Kaposi's sarcoma. A lymphatic distribution was seen in all cases. A spectrum ranging from distinctive polymorphous cellular infiltrates ultimately interpreted as Kaposi's sarcoma to "classic: Kaposi's sarcoma was found. Recognition of the former enabled retrospective recognition of Kaposi's sarcoma in four of eight transbronchial bronchial biopsies. The diagnosis of pulmonary Kaposi's sarcoma in one other patient was made solely on the basis of transbronchial biopsy. Eight patients died from pulmonary Kaposi's sarcoma; two patients are alive with extensive pulmonary Kaposi's at last follow-up. We believe that transbronchial biopsy may be useful in establishing a diagnosis of pulmonary Kaposi's sarcoma in many more patients than is generally appreciated. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Aged ; Biopsy ; Bronchi/PATHOLOGY ; Diagnosis, Differential ; Human ; Lung Neoplasms/*PATHOLOGY ; Lymphatic System/PATHOLOGY ; Male ; Middle Age ; Sarcoma, Kaposi's/COMPLICATIONS/*PATHOLOGY SO - Am J Surg Pathol 1986 May;10(5):301-11 54 UI - 86212322 AU - Mitsuyasu RT ; Colman MF ; Sun NC TI - Simultaneous occurrence of Hodgkin's disease and Kaposi's sarcoma in a patient with the acquired immune deficiency syndrome. AB - Kaposi's sarcoma and Hodgkin's disease have each been associated with abnormalities in T lymphocyte function and occur with increased frequency in the immunosuppressed host. Although the association of Kaposi's sarcoma with lymphoreticular disorders has long been recognized, only sporadic cases of Hodgkin's disease have been described in patients with the acquired immune deficiency syndrome (AIDS) in contrast to the frequent occurrence of non-Hodgkin's lymphoma in these patients. The simultaneous occurrence of Kaposi's sarcoma and Hodgkin's disease in the same lymph node is described in a patient with AIDS. This case suggests an association of AIDS with both Kaposi's sarcoma and malignant lymphomas and raises the question of a common pathogenetic mechanism. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY ; Adult ; Biopsy ; Case Report ; Hodgkin's Disease/*PATHOLOGY ; Human ; Lymph Nodes/PATHOLOGY ; Male ; Neoplasms, Multiple Primary/*PATHOLOGY ; Sarcoma, Kaposi's/*PATHOLOGY ; Skin Neoplasms/*PATHOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Med 1986 May;80(5):954-8 55 UI - 86211138 AU - Schenk P TI - Retroviruses in Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS). AB - The ultrastructure of Kaposi's sarcoma (KS) of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS) was examined electron microscopically. The tumour consisted of pleomorphic vascular endothelial structures and spindle cell formations. The KS cells contained characteristically numerous multivesicular bodies, a large number of tubuloreticular structures and abundant Weibel-Palade bodies in their cytoplasm. Virus particles, 100-120 nm in diameter, were observed budding from the plasma membrane or as free particles already separated from the plasma membrane. Many mature virions manifested a dense cylindrical-shaped core. These virus particles and the human T-cell lymphotropic retroviruses subgroup HTLV-III are ultrastructurally identical. This report is based on recent immunological research. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Cell Membrane/ MICROBIOLOGY/ULTRASTRUCTURE ; Human ; Human T-Cell Leukemia Virus/ CLASSIFICATION/*ISOLATION & PURIFICATION ; Microscopy, Electron ; Mouth Mucosa/*MICROBIOLOGY/ULTRASTRUCTURE ; Mouth Neoplasms/ *MICROBIOLOGY/ULTRASTRUCTURE ; Sarcoma, Kaposi's/*MICROBIOLOGY/ ULTRASTRUCTURE ; Skin Neoplasms/*MICROBIOLOGY/ULTRASTRUCTURE ; Support, Non-U.S. Gov't SO - Acta Otolaryngol (Stockh) 1986 Mar-Apr;101(3-4):295-8 56 UI - 86201565 AU - Tsai CC ; Giddens WE Jr ; Ochs HD ; Morton WR ; Knitter GH ; Blakley GA ; Benveniste RE TI - Retroperitoneal fibromatosis and acquired immunodeficiency syndrome in macaques: clinical and immunologic studies. AB - A simian acquired immunodeficiency syndrome (SAIDS) associated with retroperitoneal fibromatosis (RF) has been observed in several species of macaque at the Washington Regional Primate Research Center. Clinical signs were recurrent diarrhea, weight loss, mesenteric lymphadenopathy, and opportunistic infections. Most affected macaques in the later stages of illness showed marked immunodeficiency. Response of peripheral blood mononuclear cells to mitogens was impaired significantly. There was sharply depressed primary and secondary antibody response to the T-cell dependent antigen, bacteriophage phi X174. Affected monkeys did not switch from IgM to IgG antibody following a secondary immunization, as did normal macaques. Twenty-four (67%) of 36 affected animals with progressive RF or deteriorated stages of illness had hypoproteinemia and hypoalbuminemia. Quantitative serum immunoglobulins of 23 cases showed that eight (35%) had hypogammaglobulinemia, six (26%) had hypergammaglobulinemia, and the remainder (39%) were within the normal range. Opportunistic infections were predominantly bacterial pathogens. Type D retrovirus appeared to be closely associated with RF-affected macaques (12/12 or 100%). The case fatality rate (including animals sacrificed after prolonged illness) was 98%. The leading cause of death was due directly to RF lesions in 43%, to enterocolitis in 36%, septicemia in 12%, amyloidosis in 5%, and malignant lymphoma (2%). Clinical, immunologic and pathologic changes reveal an acquired immunodeficiency syndrome that has many similarities to human AIDS. SAIDS and RF may be a useful model for studying human AIDS. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/DIAGNOSIS/ *VETERINARY ; Animal ; Antibody Formation ; Fibroma/COMPLICATIONS/ DIAGNOSIS/*VETERINARY ; Immune System/PHYSIOPATHOLOGY ; In Vitro ; Lymphocyte Transformation ; Macaca nemestrina ; Mitogens/ PHARMACODYNAMICS ; Monkey Diseases/*DIAGNOSIS/IMMUNOLOGY ; Retroperitoneal Neoplasms/COMPLICATIONS/DIAGNOSIS/*VETERINARY ; Retroviridae/ISOLATION & PURIFICATION ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/IMMUNOLOGY SO - Lab Anim Sci 1986 Apr;36(2):119-25 57 UI - 86197715 AU - Ruscetti FW ; Mikovits JA ; Kalyanaraman VS ; Overton R ; Stevenson H ; Stromberg K ; Herberman RB ; Farrar WL ; Ortaldo JR TI - Analysis of effector mechanisms against HTLV-I- and HTLV-III/LAV-infected lymphoid cells. AB - Acquired immunodeficiency syndrome is associated with a viral (HTLV-III/LAV)-mediated progressive depletion of a helper/inducer T4+ T cell subset, whereas acute T cell leukemia is associated with a viral (HTLV-I)-mediated growth of the same T cell subset. Because large granular lymphocytes (LGL) with natural killer (NK) activity have been shown to spontaneously lyse several virus-infected target cells, the ability of NK cells to lyse both HTLV-I- and HTLV-III/LAV-infected lymphoid cell lines and fresh lymphocytes was explored. Normal lymphocytes (T cells and LGL), with and without pretreatment with recombinant interleukin 2 (IL 2), as well as monocytes, with and without pretreatment with interferon-gamma were employed as effectors. Both IL 2-activated T cells and NK cells were cytolytic for HTLV-I-infected targets. However, only LGL demonstrated significant spontaneous activity against HTLV-I-infected targets. Similarly, LGL showed spontaneous cytolytic activity against HTLV-III/LAV-infected targets, and this cytotoxicity was considerably augmented by IL 2. In contrast, T cells and monocytes were unable to lyse HTLV-III/LAV targets, and only minimal activity was induced by activation. LGL cells, B cells, and monocytes were infectible in vitro by high titers of HTLV-III/LAV. However, levels of reverse transcriptase found in these cultures were significantly lower than the levels in T cell cultures. In contrast, only T cells were susceptible to infection by HTLV-I. Experiments with the use of cell cocultures showed that LGL afforded T cells protection from infection by HTLV-I (as indicated by lack of transformation and viral protein expression) but not from infection by HTLV-III/LAV. Collectively, these results indicate that NK cells may play a role in protecting cells against HTLV infection. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY ; Antigens, Surface/ANALYSIS ; Cell Line ; Cytotoxicity, Immunologic ; Human ; Human T-Cell Leukemia Virus/*IMMUNOLOGY ; Immunity, Cellular ; Killer Cells, Natural/*IMMUNOLOGY ; Leukemia/*IMMUNOLOGY ; Monocytes/*IMMUNOLOGY ; Retroviridae Proteins/IMMUNOLOGY ; Reverse Transcriptase/IMMUNOLOGY ; T Lymphocytes/CLASSIFICATION/ IMMUNOLOGY/*MICROBIOLOGY ; Virus Replication SO - J Immunol 1986 May 15;136(10):3619-24 58 UI - 86196593 AU - Halbert SP ; Poiesz B ; Friedman-Kien AE ; Montagna R ; Blattner WA ; Anken M TI - Quantitative estimation by a standardized enzyme-linked immunosorbent assay of human T-cell lymphotropic virus type I antibodies in adult T-cell leukemia and acquired immune deficiency syndrome. AB - Sera from patients with adult T-cell leukemia and asymptomatic carriers of human T-cell lymphotropic virus type I (HTLV-I) from widely separated areas of the world reacted strongly in a standardized quantitative enzyme-linked immunosorbent assay procedure with HTLV-I viral antigen prepared from a strain isolated in the United States. There was a sharp differentiation of the values seen in the patients as compared with a normal population. Of the 35 acquired immune deficiency syndrome patients with Kaposi's sarcoma, only 2 were positive for HTLV-I antibodies in this test, and the distribution of the negative assay values in the other acquired immune deficiency syndrome patient sera was similar to that seen in the normal sera. Sera which contained extremely high levels of antibodies to other unrelated viruses (rubella virus, cytomegalovirus, and herpes simplex virus) all showed negative anti-HTLV-I results, in a pattern similar to the normal sera. Sera from patients with several autoimmune disease (systemic lupus erythematosus, rheumatoid arthritis, thyroiditis) as well as those with infectious mononucleosis or myeloma all also showed the normal distribution of negative results, in spite of the presence of very high levels of the autoantibodies, etc., associated with their illnesses. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY ; Adult ; Aged ; Antibodies, Viral/*ANALYSIS/IMMUNOLOGY ; Antigens, Viral/ IMMUNOLOGY ; Autoantibodies/ANALYSIS ; Autoimmune Diseases/ IMMUNOLOGY ; Carrier State/IMMUNOLOGY ; Dominican Republic ; Enzyme-Linked Immunosorbent Assay ; Human ; Human T-Cell Leukemia Virus/*IMMUNOLOGY ; Jamaica ; Japan ; Leukemia/*IMMUNOLOGY ; Middle Age ; T Lymphocytes ; United States SO - J Clin Microbiol 1986 Feb;23(2):212-6 59 UI - 86190674 AU - Katz IR ; Krown SE ; Safai B ; Oettgen HF ; Hoffmann MK TI - Antigen-specific and polyclonal B-cell responses in patients with acquired immunodeficiency disease syndrome. AB - Patients with acquired immunodeficiency disease syndrome (AIDS) show a complex spectrum of immunological abnormalities. We have examined B-lymphocyte function in 58 patients with AIDS and Kaposi's sarcoma. The major finding has been that the specific antibody response to sheep red blood cell antigen in vitro is severely depressed. Analysis of the defect in specific antibody production indicates that it is not caused by lack of T-cell help or excessive T-cell suppression, and suggests that it reflects an abnormality of the B-cell compartment itself. The defect does not affect the ability of B cells to respond to polyclonal stimulation. The possibility is considered that continuous hyperactivation of B cells in AIDS patients (as reflected in the increase in both immunoglobulin-secreting cells and serum immunoglobulin levels) results in depletion of the pool from which precursors for antigen specific B-cell responses are normally recruited. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY ; Adult ; *Antibody Formation ; Antigens, Surface/ANALYSIS ; B Lymphocytes/ *IMMUNOLOGY ; Cells, Cultured ; Erythrocytes/IMMUNOLOGY ; Helper Cells/IMMUNOLOGY ; Human ; In Vitro ; Lymphocyte Transformation ; Middle Age ; Sarcoma, Kaposi's/*IMMUNOLOGY ; Staphylococcus aureus/IMMUNOLOGY ; Suppressor Cells/IMMUNOLOGY ; T Lymphocytes/ IMMUNOLOGY SO - Clin Immunol Immunopathol 1986 Jun;39(3):359-67 60 UI - 86183904 AU - Baer DM ; Anderson ET ; Wilkinson LS TI - Acquired immune deficiency syndrome in homosexual men with Hodgkin's disease. Three case reports. AB - Fatal opportunistic infections developed in three homosexual men with Hodgkin's disease. Widely disseminated Kaposi's sarcoma developed in one, and another had persistent lymphadenopathy with a biopsy specimen showing benign follicular hyperplasia two years before the diagnosis of Hodgkin's disease. Physicians are alerted to the possible association of Hodgkin's disease and the acquired immune deficiency syndrome (AIDS). They are cautioned to consider the diagnosis of Hodgkin's disease in homosexual men with lymphadenopathy and warned of the risk of serious infections in homosexual men receiving therapy for Hodgkin's disease. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DIAGNOSIS ; Adult ; Case Report ; Hodgkin's Disease/*COMPLICATIONS/DIAGNOSIS ; Homosexuality ; Human ; Male ; Middle Age SO - Am J Med 1986 Apr;80(4):738-40 61 UI - 86173574 AU - Volberding PA TI - Kaposi's sarcoma and the acquired immunodeficiency syndrome. AB - This review has briefly summarized the place of KS in the AIDS epidemic, offering a framework for more critical evaluation of difficult therapeutic decisions. It should be expected (and it is hoped) that with the current rapid pace of AIDS research, many of these issues will be resolved shortly, and that therapy will become more rational. Until then, however, conventional approaches will be used. Given the hazards of these, it is incumbent upon the physician to remain up to date on developments in this rapidly evolving field. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DRUG THERAPY/ MICROBIOLOGY ; Antineoplastic Agents/THERAPEUTIC USE ; Antiviral Agents/THERAPEUTIC USE ; Human ; Human T-Cell Leukemia Virus ; Male ; Sarcoma, Kaposi's/*ETIOLOGY/PATHOLOGY/THERAPY ; Skin Neoplasms/ETIOLOGY/PATHOLOGY/THERAPY SO - Med Clin North Am 1986 May;70(3):665-75 62 UI - 86171094 AU - Petit JC ; Ripamonti U ; Hille J TI - Progressive changes of Kaposi's sarcoma of the gingiva and palate. Case report in an AIDS patient. AB - As the incidence of acquired immunodeficiency syndrome (AIDS) cases is rapidly increasing, it is expected that the oral lesions of Kaposi's sarcoma (KS) related to AIDS will be encountered more frequently. The progressive changes of KS of the gingiva and palate are described in an AIDS patient who has been monitored for 7 months. In the initial stage, the oral manifestations of KS can be confused with various other lesions. The histopathological appearance includes proliferating slit-like vascular channels and scattered macrophages containing numerous hyaline, eosinophilic granules. Rapid neoplastic proliferation seems to be related to cyclical episodes of impaired immunity. MH - *Acquired Immunodeficiency Syndrome/DIAGNOSIS ; Adult ; Case Report ; Diagnosis, Differential ; Gingival Neoplasms/*PATHOLOGY ; Homosexuality ; Human ; Male ; Mouth Diseases/PATHOLOGY ; Palatal Neoplasms/*PATHOLOGY ; Sarcoma, Kaposi's/*PATHOLOGY ; Time Factors ; Ulcer/PATHOLOGY SO - J Periodontol 1986 Mar;57(3):159-63 63 UI - 86170648 AU - Real FX ; Oettgen HF ; Krown SE TI - Kaposi's sarcoma and the acquired immunodeficiency syndrome: treatment with high and low doses of recombinant leukocyte A interferon. AB - The efficacy of recombinant leukocyte A interferon (rIFN-alpha A [Roferon-A, Hoffman-La Roche, Nutley, NJ]) treatment of Kaposi's sarcoma in patients with acquired immunodeficiency syndrome was evaluated in sequential trials using high doses (36 X 10(6) units) and low doses (3 X 10(6) units) of interferon. A major response was seen in 38% of patients treated at the high dose, with a median response duration of 18 months. At the low dose, the major response rate was 3%; dose escalation to 36 X 10(6) units resulted in an additional major response rate of 17% in low-dose nonresponders, with a median response duration of 10 months. Four of 11 patients who achieved a complete response remain free of disease, whereas all partial responders have shown disease progression. Unacceptable toxicity occurred in 27% of patients initially treated at the high dose and only in 10% of those who had progressive dose escalation up to 36 X 10(6) units. Prior opportunistic infections correlated negatively with therapeutic response, whereas large tumor burden and gastrointestinal involvement did not. Responding patients showed a significantly longer survival and a lower incidence of subsequent opportunistic infections than nonresponders. However, from our study we cannot determine whether rIFN-alpha A has an effect on the natural history of Kaposi's sarcoma in patients with the acquired immunodeficiency syndrome. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*THERAPY ; Adult ; Comparative Study ; Dose-Response Relationship, Drug ; Human ; Interferon Type I/ADMINISTRATION & DOSAGE/TOXICITY/*THERAPEUTIC USE ; Middle Age ; Recombinant Proteins/ADMINISTRATION & DOSAGE/ TOXICITY/*THERAPEUTIC USE ; Risk ; Sarcoma, Kaposi's/ COMPLICATIONS/*THERAPY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - J Clin Oncol 1986 Apr;4(4):544-51 64 UI - 86162692 AU - Weinberg ED TI - Iron, infection, and neoplasia. AB - In nearly all forms of life, the number and diversity of enzymes that contain iron or that depend on the presence of this metal for activity are impressive. Not surprisingly, chemical mechanisms have been evolved by many organisms that permit them to solubilize and acquire iron while at the same time depriving their competitors or their pathogens of this element. Proteins such as transferrin and lactoferrin that are employed by vertebrate hosts for iron transport and acquisition can, to some extent, withhold the metal from the siderophores of invading bacteria and fungi. Attempts also are made by animal hosts to withhold iron from protozoa and neoplastic cells. Unfortunately, pathogenic microorganisms have developed a variety of counter measures that are especially dangerous in hosts stressed by iron overload in specific fluids, tissues, or cells. In recent years, however, a number of possible methods and agents for strengthening iron-withholding defense have become apparent. Nearly 3,000 papers on various aspects of iron withholding are contained in the 18-year Medline Database and numerous reviews have been published since 1966. The present paper will focus on developments that have been reported within the past 2 1/2 years. MH - Acquired Immunodeficiency Syndrome/BLOOD/MICROBIOLOGY ; Animal ; Bacteria/METABOLISM ; Carrier Proteins/METABOLISM/*THERAPEUTIC USE ; Ferritin/BLOOD ; Food, Fortified/TOXICITY ; Fungi/ METABOLISM ; Hemochromatosis/COMPLICATIONS ; Human ; Infection/ PHYSIOPATHOLOGY ; Interleukin 1/PHYSIOLOGY ; Iron/BLOOD/ *METABOLISM/TOXICITY ; Leukemia, Lymphoblastic/BLOOD/MICROBIOLOGY ; Liver Neoplasms/CHEMICALLY INDUCED ; Mice ; Neoplasms/BLOOD/ *PHYSIOPATHOLOGY ; Protozoa/METABOLISM ; Review ; Transferrin/ METABOLISM SO - Clin Physiol Biochem 1986;4(1):50-60 65 UI - 86156112 AU - Rutgers JL ; Wieczorek R ; Bonetti F ; Kaplan KL ; Posnett DN ; Friedman-Kien AE ; Knowles DM 2d TI - The expression of endothelial cell surface antigens by AIDS-associated Kaposi's sarcoma. Evidence for a vascular endothelial cell origin. AB - The authors investigated 19 cases of Kaposi's sarcoma (KS) obtained from patients with the acquired immune deficiency syndrome (AIDS) for their expression of Factor VIII-related antigen (FVIIIRAg), HLA-DR (Ia) antigens, OKM1, and three distinctive vascular, but not lymphatic, endothelial-cell-associated antigens, E92, OKM5, and HCl. Antigen expression was demonstrated by immunoperoxidase staining of cryostat sections. FVIIIRAg is strongly expressed by the cells lining the vascular spaces (VCs) but is absent, weakly or focally, and variably expressed by the spindle cell (SC) component of KS. The VC component of each KS lesion examined strongly expressed E92, moderately expressed HCl, and weakly expressed OKM5. In contrast, the entire SC component of each KS lesion studied strongly expressed E92 and OKM5 and weakly expressed HCl. Neither the VCs nor the SCs expressed OKM1. These studies provide strong and compelling evidence for the vascular endothelial cell histogenesis of both the vascular and spindle cell components of KS, demonstrate the intertumor and intratumor phenotypic heterogeneity of KS, and suggest that monoclonal antibodies OKM5 and anti-E92 are the best currently available immunohistochemical markers for identifying the spindle cell component of AIDS-associated KS in cryostat sections. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Antigens, Neoplasm/*ANALYSIS ; Antigens, Surface/*ANALYSIS ; Blood Vessels/ IMMUNOLOGY/PATHOLOGY ; Endothelium/IMMUNOLOGY/PATHOLOGY ; Histocytochemistry ; Human ; Immunochemistry ; *Lymph Nodes ; Lymphatic Diseases/COMPLICATIONS/*IMMUNOLOGY/PATHOLOGY ; Neoplasms ; Sarcoma, Kaposi's/COMPLICATIONS/*IMMUNOLOGY/PATHOLOGY ; Skin Neoplasms/COMPLICATIONS/*IMMUNOLOGY/PATHOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Pathol 1986 Mar;122(3):493-9 66 UI - 86150358 AU - Nyberg DA ; Jeffrey RB Jr ; Federle MP ; Bottles K ; Abrams DI TI - AIDS-related lymphomas: evaluation by abdominal CT. AB - Recent evidence indicates that individuals with acquired immunodeficiency syndrome (AIDS) or those at high risk for AIDS have an increased occurrence of lymphoma. AIDS-related lymphomas (ARLs) often present with an advanced stage of disease and highly malignant histologic subtypes. This study reviewed the abdominal computed tomographic (CT) findings in 29 patients with ARL, including ten with Hodgkin disease (HD) and 19 with non-Hodgkin lymphoma (NHL). Focal splenic and hepatic involvement was more common in both AIDS-related HD (10%) and NHL (26%) than reported in the non-AIDS population. In addition, mesenteric lymphadenopathy was demonstrated in 20% of patients with AIDS-related HD, compared with less than 5% in non-AIDS patients. In this series, patients with NHL had pelvic nodal masses in 37%, bowel involvement in 26%, and renal lesions in 11%. The authors conclude that ARLs are highly aggressive neoplasms that often present with atypical features compared with lymphomas in other patients. Potential problems in the CT interpretation of ARL for homosexual men are discussed. MH - Abdomen/*RADIOGRAPHY ; Acquired Immunodeficiency Syndrome/ *RADIOGRAPHY ; Adult ; Human ; Lymphoma/*RADIOGRAPHY ; Male ; Middle Age ; Tomography, X-Ray Computed SO - Radiology 1986 Apr;159(1):59-63 67 UI - 86144032 AU - Kikukawa R ; Koyanagi Y ; Harada S ; Kobayashi N ; Hatanaka M ; Yamamoto N TI - Differential susceptibility to the acquired immunodeficiency syndrome retrovirus in cloned cells of human leukemic T-cell line Molt-4. AB - Cells of human leukemic T-cell line Molt-4 which were cloned in soft agarose from individual colonies were analyzed for the cytopathic effect and viral antigen expression after human T-cell lymphotropic virus type III infection. The induction of cytopathic effect and viral antigens by the infection varied significantly among the different cell clones. These clones did not show significant differences in the amount of OKT-4 antigen, a possible surface receptor for acquired immunodeficiency syndrome virus. Moreover, the virus-producing ability and the susceptibility to the virus of each clone appeared to be separable. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY ; Antigens, Viral/ *ANALYSIS/BIOSYNTHESIS ; Cell Line ; Clone Cells ; Cytopathogenic Effect, Viral ; Human ; Human T-Cell Leukemia Virus/*IMMUNOLOGY ; Leukemia/*IMMUNOLOGY ; Reverse Transcriptase/ANALYSIS ; Support, Non-U.S. Gov't SO - J Virol 1986 Mar;57(3):1159-62 68 UI - 86133157 AU - Krown SE ; Real FX ; Vadhan-Raj S ; Cunningham-Rundles S ; Krim M ; Wong G ; Oettgen HF TI - Kaposi's sarcoma and the acquired immune deficiency syndrome. Treatment with recombinant interferon alpha and analysis of prognostic factors. AB - Interferon alfa-2a (Roferon-A, Hoffmann-La Roche Inc., Nutley, NJ) was used to treat sequential groups of patients with Kaposi's sarcoma associated with the acquired immune deficiency syndrome (AIDS). Major antitumor effects (complete or partial responses) were observed in 38% of the patients treated initially with high-dose interferon alfa-2a and in 17% of patients in whom the dose was increased after low-dose treatment failed. A low dose of interferon alfa-2a was ineffective; one patient (3%) showed a partial response. Patients whose tumors responded to interferon treatment showed a significantly lower rate of opportunistic infection, as well as a longer survival than nonresponders. The status of pretreatment immune function was important in predicting the response to interferon treatment. The implication of these findings with respect to understanding the mechanism of action of interferon and the definition of the most appropriate patients for interferon treatment are discussed. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Antigens, Surface/ANALYSIS ; Human ; Immunity ; Interferon Type I/ *THERAPEUTIC USE ; Male ; Prognosis ; Recombinant Proteins/ *THERAPEUTIC USE ; Sarcoma, Kaposi's/ETIOLOGY/PHYSIOPATHOLOGY/ *THERAPY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/IMMUNOLOGY SO - Cancer 1986 Apr 15;57(8 Suppl):1662-5 69 UI - 86133156 AU - Mitsuyasu RT ; Taylor JM ; Glaspy J ; Fahey JL TI - Heterogeneity of epidemic Kaposi's sarcoma. Implications for therapy. AB - Kaposi's sarcoma (KS) in acquired immune deficiency syndrome (AIDS) is a new manifestation of a previously rare disease, and generally has a fatal course. Variations in the clinical course and in response to treatment by patients with this disease suggest that specific immunologic or clinical parameters may be important in the prognosis. Retrospective analyses of clinical parameters with respect to survival in 96 patients with epidemic Kaposi's sarcoma indicated that earlier tumor stage, the lack of prior opportunistic infections, and the absence of systemic symptoms correlated most closely with survival. Sixteen immune parameters were also assessed for their prognostic value. Total T4 (CD-4) cell number levels and the T4: T8 ratio correlated most closely with survival. Response to treatment with recombinant alpha interferons, while not well correlated with tumor stage, was more frequent in patients without systemic symptoms or a history or prior opportunistic infections. Treatment response was associated with a greater degree of intact T-cell function. These findings emphasize the importance of cellular immunity in the pathogenesis and subsequent course of patients with epidemic Kaposi's sarcoma, suggesting that different therapeutic strategies may be necessary to address specific prognostic subgroups. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Antigen-Antibody Complex/ANALYSIS ; Antigens, Surface/ANALYSIS ; Human ; IgA/ANALYSIS ; Interferon Type I/THERAPEUTIC USE ; Leukocyte Count ; Lymphocyte Transformation ; Prognosis ; Recombinant Proteins/THERAPEUTIC USE ; Sarcoma, Kaposi's/ETIOLOGY/ *IMMUNOLOGY/THERAPY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/IMMUNOLOGY SO - Cancer 1986 Apr 15;57(8 Suppl):1657-61 70 UI - 86131982 AU - Taylor J ; Afrasiabi R ; Fahey JL ; Korns E ; Weaver M ; Mitsuysau R TI - Prognostically significant classification of immune changes in AIDS with Kaposi's sarcoma. AB - Sixteen immunological parameters were assessed quantitatively for their value in providing an immunologically-based and prognostically significant classification of the immune alteration in 97 patients with AIDS and Kaposi's sarcoma (AIDS-KS). The dimensions of reductions in the T4 (T helper-inducer cells) subpopulation of lymphoid cells in the T4-T8 ratio were found to correlate most closely with prognosis. Most other immunological changes did not relate to clinical course. T4 lymphocyte levels greater than 300/microL and a T4-T8 ratio greater than 0.5 indicated a relatively good prognosis, eg, 85% to 95% survival at 12 months. T4 levels less than 100/microL and/or a T4-T8 ratio less than 0.2 had a very poor prognosis, eg, less than 25% survival at 12 months. Intermediate T4 levels and T4-T8 ratios had intermediate prognosis. These immunological findings were found to have independent prognostic value for survival when compared with disease classifications based on tumor stage (I through IV) or on clinical status A (without) or B (with fever, night sweats, or weight loss). Reduced proliferative capacity, increased OKT10 antigen expression, elevated levels of serum IgA, and immune complexes also correlated with prognosis. Elevated levels of serum IgG, cellular HLA-DR expression, and skin test anergy occurred frequently in AIDS-KS but did not have prognostic significance. Variations in level of total lymphocyte, T8 (T suppressor/cytotoxic) cell, gamma FcR receptor-positive cell number, NK activity, or level of serum IgM were less common in AIDS-KS and did not correlate with prognosis. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY/MORTALITY ; Adult ; Antibodies, Viral/ANALYSIS ; Antigens, Surface/ANALYSIS ; Human ; Immunoglobulins/ANALYSIS ; Infection/ETIOLOGY ; Male ; Middle Age ; Neoplasm Staging ; Prognosis ; Sarcoma, Kaposi's/ *IMMUNOLOGY/MORTALITY ; Skin Tests ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Blood 1986 Mar;67(3):666-71 71 UI - 86131974 AU - Groopman JE ; Sullivan JL ; Mulder C ; Ginsburg D ; Orkin SH ; O'Hara CJ ; Falchuk K ; Wong-Staal F ; Gallo RC TI - Pathogenesis of B cell lymphoma in a patient with AIDS. AB - Lymphoma occurs at increased frequency in patients with the acquired immunodeficiency syndrome (AIDS). We studied, using serologic and molecular techniques, one such lymphoma for (a) evidence of infection with human T lymphotropic virus, type III (HTLV-III), and Epstein-Barr virus (EBV), (b) monoclonal rearrangement of immunoglobulin and T cell receptor genes, and (c) rearrangement of the c-myc oncogene. Immunoglobulin and T cell receptor gene studies demonstrated that the tumor was of monoclonal B cell origin. Similar to cases of Burkitt's lymphoma unrelated to AIDS, there were DNA sequences in the lymphoma that hybridized to EBV-specific probes and demonstrated evidence of c-myc rearrangement. HTLV-III sequences were not detected in the malignant B cells. The pathogenesis of some B cell neoplasms in patients with the syndrome may involve transformation by EBV and deregulation of oncogene expression without direct infection of the malignant B cells by HTLV-III. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS ; Adult ; Antibodies, Viral/ANALYSIS ; B Lymphocytes ; Case Report ; Epstein-Barr Virus/GENETICS ; Human ; Human T-Cell Leukemia Virus/ GENETICS ; Immunoglobulins/GENETICS ; Lymphoma/*ETIOLOGY/ PATHOLOGY ; Male ; Oncogenes ; Recombination, Genetic ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Blood 1986 Mar;67(3):612-5 72 UI - 86129710 AU - Katner HP ; Pankey GA ; Flaum MA ; Dalovisio JR ; Cortez LM ; DeShazo RD TI - Kaposi's sarcoma with a non-Hodgkin's lymphoma. Its association in a male homosexual with human T-cell lymphotropic virus type III infection. AB - Combined tumor syndromes, specifically reticuloendothelial malignancies and Kaposi's sarcoma, have long been recognized. With the recognition of the acquired immunodeficiency syndrome (AIDS), several patients with concurrent non-Hodgkin's lymphoma and Kaposi's sarcoma have been reported at high risk for developing AIDS. The present Centers for Disease Control definition of AIDS excludes these patients on the assumption that one tumor is affecting the cellular immunity, allowing for the development of the second malignancy. In evaluating such a patient who had serologic evidence of human T-cell lymphotropic virus type III infection, the probable cause of AIDS, we have reviewed reports of patients with similar concurrent malignancies before and since the onset of the AIDS epidemic. We conclude that patients in high-risk groups for AIDS who develop similar combined tumor syndromes should be classified as having AIDS. MH - Acquired Immunodeficiency Syndrome/DIAGNOSIS/*ETIOLOGY ; Adult ; Case Report ; Homosexuality ; Human ; Lymphoma/*COMPLICATIONS/ DIAGNOSIS ; Male ; Sarcoma, Kaposi's/*COMPLICATIONS/DIAGNOSIS SO - Arch Intern Med 1986 Feb;146(2):393-4 73 UI - 86107412 AU - Leibman AJ ; Gold BM TI - Gastric manifestations of autoimmune deficiency syndrome-related Kaposi's sarcoma on computed tomography. AB - The computed tomography manifestations of Kaposi's sarcoma in the stomach have not been described. A case of autoimmune deficiency syndrome-related Kaposi's sarcoma with stomach involvement documented on computed tomography is presented. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS ; Adult ; Case Report ; Human ; Male ; Sarcoma, Kaposi's/ETIOLOGY/*RADIOGRAPHY ; Stomach/RADIOGRAPHY ; Stomach Neoplasms/ETIOLOGY/*RADIOGRAPHY ; Tomography, X-Ray Computed SO - J Comput Tomogr 1986 Jan;10(1):85-8 74 UI - 86100520 AU - Real FX ; Krown SE ; Koziner B TI - Steroid-related development of Kaposi's sarcoma in a homosexual man with Burkitt's lymphoma. AB - The development of Kaposi's sarcoma has been associated with either iatrogenic or disease-related immunodeficiency. This report describes a homosexual man who presented with Burkitt's lymphoma and later had pneumonitis, which was treated with a high dose of corticosteroids. Kaposi's sarcoma subsequently developed, and regressed completely when the chemotherapy and corticosteroid therapy were withdrawn. The evidence from the literature relating corticosteroid therapy to the development of Kaposi's sarcoma is discussed, as well as the possible multifactorial origin of the immunodeficiency in which setting this tumor occurs. The observations in this patient suggest that corticosteroids should be used with extreme caution in patients with acquired immunodeficiency and those at risk for its development. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY ; Adult ; Antineoplastic Agents, Combined/*THERAPEUTIC USE ; Burkitt's Lymphoma/*COMPLICATIONS/DRUG THERAPY ; Case Report ; *Homosexuality ; Human ; Male ; Pneumonia/DRUG THERAPY ; Prednisone/*ADVERSE EFFECTS/THERAPEUTIC USE ; Risk ; Sarcoma, Kaposi's/*CHEMICALLY INDUCED/IMMUNOLOGY ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. SO - Am J Med 1986 Jan;80(1):119-22 75 UI - 86090927 AU - Jegasothy BV TI - The role of tissue typing in cutaneous oncology. AB - The typing of cells in the skin with specific monoclonal antibodies is now routine. Such tissue typing appears to play a critical role in the early diagnosis, accurate classification, and therapeutic decisions for cutaneous oncology, especially lymphomas. Identification and production of tumor-specific antibodies will further enhance the potential of these reagents in oncology. MH - Acquired Immunodeficiency Syndrome/IMMUNOLOGY ; Antibodies, Monoclonal/BIOSYNTHESIS/*DIAGNOSTIC USE ; Carcinoma, Squamous Cell/DIAGNOSIS ; Cell Transformation, Neoplastic ; *Histocompatibility Testing ; Human ; Lymphocytes/PATHOLOGY ; Lymphoma/DIAGNOSIS ; Melanoma/DIAGNOSIS ; Review ; Skin Neoplasms/ *DIAGNOSIS ; Support, U.S. Gov't, Non-P.H.S. ; T Lymphocytes SO - Med Clin North Am 1986 Jan;70(1):177-85 76 UI - 86090925 AU - Muggia FM ; Lonberg M TI - Kaposi's sarcoma and AIDS. AB - Mucocutaneous lesions are often a prominent manifestation of the acquired immune deficiency syndrome (AIDS). Patients with this syndrome are susceptible to a number of opportunistic skin infections as well as an aggressive form of Kaposi's sarcoma. The diagnosis, the clinical setting, and the treatment of these diseases are discussed. MH - Acquired Immunodeficiency Syndrome/*COMPLICATIONS/ETIOLOGY ; Cytomegalic Inclusion Disease/ETIOLOGY ; Human ; Human T-Cell Leukemia Virus/ISOLATION & PURIFICATION ; Review ; Sarcoma, Kaposi's/*ETIOLOGY/THERAPY ; Skin Diseases, Infectious/ETIOLOGY ; Skin Neoplasms/*ETIOLOGY/THERAPY SO - Med Clin North Am 1986 Jan;70(1):139-54 77 UI - 86073809 AU - Jeffrey RB Jr ; Nyberg DA ; Bottles K ; Abrams DI ; Federle MP ; Wall SD ; Wing VW ; Laing FC TI - Abdominal CT in acquired immunodeficiency syndrome. AB - Acquired immunodeficiency syndrome (AIDS) is a lethal infectious disease that has reached epidemic proportions in urban centers of the United States. Intraabdominal opportunistic infections and malignancies are common features of this syndrome. A prodromal phase or possibly milder form of infection is known as the AIDS-related complex. Abdominal computed tomography (CT) in patients with AIDS-related complex often demonstrates a triad of mild retroperitoneal and mesenteric adenopathy, splenomegaly, and perirectal inflammation. Lymph node enlargement greater than 1.5 cm is unusual in the AIDS-related complex and should prompt CT-guided biopsy. Abdominal adenopathy (greater than 1.5 cm) in AIDS, in our experience, is most commonly related to non-Hodgkin lymphoma, Kaposi sarcoma, or infection with Mycobacterium avium-intracellulare. In most instances, CT-guided biopsy with appropriate staining technique can readily distinguish these entities. However, the subtyping of non-Hodgkin lymphoma by fine-needle aspiration biopsy alone remains controversial. Unusual features of abdominal malignancies are common in AIDS. These include a purely lymphadenopathic form of AIDS-related Kaposi sarcoma and a predilection for extranodal sites of lymphoma in AIDS. In general, patients with AIDS-related lymphoma present with advanced stages of disease with highly malignant histologic subtypes. Abdominal CT may be useful clinically for diagnosing intraabdominal complications of AIDS. MH - Abdomen/*RADIOGRAPHY ; Abdominal Neoplasms/ETIOLOGY/*RADIOGRAPHY ; Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY ; Gastrointestinal Diseases/ETIOLOGY/RADIOGRAPHY ; Human ; Infection/ETIOLOGY/RADIOGRAPHY ; Lymphatic Diseases/ETIOLOGY/ RADIOGRAPHY ; Lymphoma/ETIOLOGY/*RADIOGRAPHY ; Review ; Sarcoma, Kaposi's/ETIOLOGY/*RADIOGRAPHY ; *Tomography, X-Ray Computed SO - AJR 1986 Jan;146(1):7-13 78 UI - 86073779 AU - Wall SD ; Ominsky S ; Altman DF ; Perkins CL ; Sollitto R ; Goldberg HI ; Margulis AR TI - Multifocal abnormalities of the gastrointestinal tract in AIDS. AB - On review of 63 barium sulfate examinations in 44 patients with acquired immunodeficiency syndrome (AIDS), 61% of the 23 single-contrast examinations and 98% of the 40 double-contrast examinations were abnormal. Abnormalities involved all areas of the gastrointestinal (GI) tract and covered a wide spectrum of findings including thickened folds, nodularity, increased secretions, superficial erosions, ulcerations, plaque formation, and tumor mass. Abnormalities, when present, were most commonly multifocal (three or more sites) on upper GI study (64%) and barium enema (69%). Thirty-eight patients (86%) had at least one abnormal study; 27 of these patients had multifocal disease in either the upper or lower tract separately or combined. The most common site of abnormality was the duodenum on upper GI study and the sigmoid colon on barium enema. In 27 cases the radiographic abnormalities could be specifically correlated with a malignancy or an opportunistic infection by endoscopy, colonoscopy, culture, biopsy, or autopsy. Multifocal disease of the upper and/or lower GI tract, especially when the duodenum is involved, should suggest AIDS even in patients not thought to be at high risk for the disease. MH - Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY ; Adult ; Barium Sulfate/DIAGNOSTIC USE ; Enema ; Gastrointestinal Diseases/ETIOLOGY/*RADIOGRAPHY ; Gastrointestinal Neoplasms/ ETIOLOGY/RADIOGRAPHY ; Homosexuality ; Human ; Lymphoma/ETIOLOGY/ *RADIOGRAPHY ; Male ; Middle Age ; Sarcoma, Kaposi's/ETIOLOGY/ *RADIOGRAPHY SO - AJR 1986 Jan;146(1):1-5 79 UI - 86053253 AU - Vadhan-Raj S ; Wong G ; Gnecco C ; Cunningham-Rundles S ; Krim M ; Real FX ; Oettgen HF ; Krown SE TI - Immunological variables as predictors of prognosis in patients with Kaposi's sarcoma and the acquired immunodeficiency syndrome. AB - Multivariate analysis was used to identify which of a large number of pretreatment immunological parameters correlated with therapeutic response, subsequent development of opportunistic infection, and survival from the time of diagnosis in a group of 70 patients with Kaposi's sarcoma and acquired immunodeficiency syndrome treated with recombinant leukocyte A interferon. In a logistic regression model, delayed type hypersensitivity response to one or more recall antigens and high proliferative response to Escherichia coli were significant predictors for response to recombinant leukocyte A interferon (for the model, P = 0.01). For prediction of the development of opportunistic infection, the model selected low proliferative responses to phytohemagglutinin and E. coli (P less than 0.001). Favorable factors predicting survival in the Cox regression model were the absence of endogenous serum interferon activity and a high proliferative response to E. coli (P less than 0.001). The estimated median survival for the group with endogenous serum interferon activity and low E. coli response was 12 months; the median has not yet been reached for the group with no serum interferon and a high E. coli response. We conclude that immunological parameters may be useful in predicting prognosis in patients with Kaposi's sarcoma and acquired immunodeficiency syndrome. MH - Acquired Immunodeficiency Syndrome/*IMMUNOLOGY/THERAPY ; Antigens, Surface/ANALYSIS ; Beta 2 Microglobulin/ANALYSIS ; Human ; Hypersensitivity, Delayed/IMMUNOLOGY ; Immunoglobulins/ ANALYSIS ; Interferon Type I/THERAPEUTIC USE ; Interferons/BLOOD ; Killer Cells, Natural/IMMUNOLOGY ; Lymphocyte Transformation ; Prognosis ; Recombinant Proteins/THERAPEUTIC USE ; Sarcoma, Kaposi's/*IMMUNOLOGY/THERAPY ; Skin Tests ; Support, Non-U.S. Gov't ; Support, U.S. Gov't, P.H.S. ; T Lymphocytes/ CLASSIFICATION ; Time Factors SO - Cancer Res 1986 Jan;46(1):417-25 80 UI - 86053061 AU - Harper ME ; Marselle LM TI - In situ hybridization--application to gene localization and RNA detection. AB - In situ hybridization offers a direct approach for localization and quantitation of nucleic acid sequences in cellular preparations. Recent improvements in technology and methodology make possible the detection of DNA and RNA of relatively low copy number. For example, development of in situ hybridization methods for detection of single copy DNA sequences on mitotic chromosomes has led to general use of this technique for gene mapping of the human genome. More recently, improvements in methodology for detection of low abundancy RNA make possible a facilitated analysis of gene expression, both from cellular genes and exogenous sequences, such as viral genomes. In situ hybridization is now a powerful method for studying nucleic acid organization and function in normal cells, as well as in malignant cells, which should contribute to better understanding of the cell transformation process. MH - Acquired Immunodeficiency Syndrome/ETIOLOGY/FAMILIAL & GENETIC ; Base Sequence ; Chromosome Banding ; *Chromosome Mapping ; Human ; Human T-Cell Leukemia Virus/GENETICS ; Neoplasms/*FAMILIAL & GENETIC ; *Nucleic Acid Hybridization ; *Oncogenes ; RNA, Neoplasm/*GENETICS ; RNA, Viral/GENETICS SO - Cancer Genet Cytogenet 1986 Jan 1;19(1-2):73-80