Oropharyngeal Kaposi's sarcoma. Report of two cases and review of the literature

Review of HIV-Related Cytopathology

Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.

State of the art: gastrointestinal malignancies in the human immunodeficiency virus (HIV) population

The gastrointestinal tract is one of the most common sites for the development of primary neoplasms arising in patients with pre-existing infection with the human immunodeficiency virus (HIV). Over the past decade, new information on the clinical manifestation, natural history, treatment options, and related toxicity have been reported, mostly notably the integration of highly active antiretroviral therapy (HAART). The following is a concise review summarizing the current state-of-the-art for GI tract malignancies in the HIV-positive patient and is designed to assist the clinical oncology team in developing a rationale plan when caring for these patients.

Upper airway obstruction secondary to acquired immunodeficiency syndrome-related Kaposi's sarcoma

A 45-year-old man with a history of intravenous drug use presented with acute respiratory distress. A pulsus paradoxus of 42 mm Hg, accessory respiratory muscle use and stridor were present. Examination of the oropharynx revealed multiple 1 to 2 cm purple lesions of the gingiva and hard palate. A purple tumor mass in the posterior pharynx obstructed the view of the larynx. An emergency tracheostomy was performed resulting in hemorrhage into the respiratory tract. Autopsy revealed disseminated Kaposi's sarcoma and large blood clots in the trachea and main stem bronchus. This case illustrates the occurrence of life threatening involvement of the upper aerodigestive tract with Kaposi's sarcoma and hemorrhagic complications resulting from surgical manipulation.