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Ara T, Endo T, Goto H, Kasahara K, Hasegawa Y, Yokoyama S, Shiratori S, Nakagawa M, Kuwahara K, Takakuwa E, Hashino S, Teshima T. Antiretroviral therapy achieved metabolic complete remission of hepatic AIDS related Epstein-Barr virus-associated smooth muscle tumor. Antivir Ther 2022; 27:13596535221126828. [DOI: 10.1177/13596535221126828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare mesenchymal tumor which occurs in immunocompromised patients. The immune status is an important factor in the treatment of EBV-SMTs, but the efficacy of antiretroviral therapy (ART) is not elucidated in acquired immune deficiency syndrome (AIDS) related EBV-SMTs. Here, we report the first successful case of a 29-year-old man with hepatic AIDS related EBV-SMT treated with ART solely. Positron emission tomography scan was useful for the evaluation of disease status. Recent advances in ART that enables to restore patient’s immune status rapidly may change the treatment strategy in AIDS related EBV-SMT.
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Affiliation(s)
- Takahide Ara
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
| | - Tomoyuki Endo
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Goto
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
| | - Kohei Kasahara
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yuta Hasegawa
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
| | - Shota Yokoyama
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
| | - Souichi Shiratori
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Masao Nakagawa
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Ken Kuwahara
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Emi Takakuwa
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Satoshi Hashino
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
- Hokkaido University Health Care Center, Sapporo, Japan
| | - Takanori Teshima
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- HIV infection Medical Support Center, Hokkaido University Hospital, Sapporo, Japan
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Laohawetwanit T, Wanpiyarat N, Lerttanatum N. Useful histopathologic features for diagnosing focal liver lesions with spindle cell morphology: A clinicopathologic study. Ann Diagn Pathol 2022; 59:151975. [DOI: 10.1016/j.anndiagpath.2022.151975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/01/2022]
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Barrett K, Tavakoli S, McGinity M, Gilbert A. Intracranial Epstein-Barr virus-associated smooth muscle tumor with superimposed cryptococcal infection: A case report. Medicine (Baltimore) 2022; 101:e28806. [PMID: 35244038 PMCID: PMC8896472 DOI: 10.1097/md.0000000000028806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/25/2022] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Epstein-Barr virus-associated smooth muscle tumors (EBV-SMT) are rare, virally-induced malignancies that occur almost exclusively in immunocompromised individuals. We report a very rare case of a dura-based EBV-SMT with superimposed local cryptococcal infection. PATIENT CONCERNS An adult male with a history of untreated acquired immunodeficiency syndrome presented to our hospital with worsening headaches, diarrhea, and diffuse myalgias. DIAGNOSES Blood cultures were positive for methicillin-resistant Staphylococcus aureus and Cryptococcus neoformans serum antigen. Magnetic resonance imaging revealed 2 adjacent enhancing masses in the right temporal lobe, perilesional edema, and mass effect of the right lateral ventricle. Histological examination and immunohistochemical stains of the surgical specimen were consistent with EBV-SMT. Cryptococcus organisms were identified within the neoplasm. INTERVENTIONS The patient underwent complete tumor resection, received an extended course of amphotericin and flucytosine, and was restarted on antiretroviral therapy. OUTCOMES The patient was discharged from the hospital with no focal neurological deficits. LESSONS Epstein-Barr virus associated smooth muscle tumors are rare malignancies that occur in immunocompromised patients. Prognosis is largely dependent on immune reconstitution and treatment of concomitant infections.
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Affiliation(s)
- Kaylyn Barrett
- University of Texas Health San Antonio Long School of Medicine, TX
| | - Sam Tavakoli
- University of Texas Health San Antonio Department of Neurosurgery, TX
| | - Michael McGinity
- University of Texas Health San Antonio Department of Neurosurgery, TX
| | - Andrea Gilbert
- University of Texas Health San Antonio Department of Pathology and Laboratory Medicine, TX
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Chong YB, Lu PL, Ma YC, Yin HL, Chang CH. Epstein-Barr Virus-Associated Smooth Muscle Tumor and Its Correlation With CD4 Levels in a Patient With HIV Infection. Front Cell Infect Microbiol 2022; 12:725342. [PMID: 35141174 PMCID: PMC8818939 DOI: 10.3389/fcimb.2022.725342] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/03/2022] [Indexed: 11/28/2022] Open
Abstract
Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare tumor found in immunocompromised patients, and its treatment is not well-established. A role for antiretroviral therapy in human immunodeficiency virus (HIV)-related EBV-SMT has been proposed; however, the relevance of tumor size, CD4 levels, and immune reconstitution inflammatory syndrome (IRIS) has not been previously reported. We present the first case, to our knowledge, of a tumor that shrank in association with elevated CD4 counts. IRIS occurred in this case following antiretroviral therapy. This finding highlights the importance of the immune response in HIV-related EBV-SMT.
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Affiliation(s)
- Yoon Bin Chong
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Liang Lu
- School of Medicine for Post-Baccalaureate, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chun Ma
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Ling Yin
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hui Chang
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- *Correspondence: Chih-Hui Chang,
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师 琴, 汤 文, 贺 湘, 田 鑫. [Epstein-Barr virus-associated smooth muscle tumor in a girl]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:739-742. [PMID: 34266534 PMCID: PMC8292655 DOI: 10.7499/j.issn.1008-8830.2103152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
A girl, aged 7 years, was admitted due to pain in both lower limbs for more than one year. Lumbar MRI showed soft tissue masses in the paravertebral region. Cerebral MRI showed nodular masses in the cavernous sinus at both sides. Chest CT showed high-density nodules in the outer basal segment of the right inferior lobe and the anterior segment of the left upper lobe of the lung. Biopsy of lumbar lesions showed Epstein-Barr (EB) virus-related smooth muscle tumor. Genetic testing showed a de novo mutation, c.725_730delAGAGTA (p.K242_S243del), in the ITK gene. The masses in the lumbar vertebra were removed by surgery, and then the pain in both lower limbs disappeared. This article reports a case of EB virus-related smooth muscle tumor with a deletion mutation in the ITK gene, which provides experience for the diagnosis and treatment of this disease.
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Affiliation(s)
- 琴 师
- />湖南省人民医院/湖南师范大学附属第一医院儿童医学中心血液肿瘤科, 湖南长沙 410005Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
| | - 文芳 汤
- />湖南省人民医院/湖南师范大学附属第一医院儿童医学中心血液肿瘤科, 湖南长沙 410005Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
| | - 湘玲 贺
- />湖南省人民医院/湖南师范大学附属第一医院儿童医学中心血液肿瘤科, 湖南长沙 410005Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
| | - 鑫 田
- />湖南省人民医院/湖南师范大学附属第一医院儿童医学中心血液肿瘤科, 湖南长沙 410005Department of Hematology and Oncology, Children's Medical Center, Hunan Provincial People's Hospital/First Affiliated Hospital of Hunan Normal University, Changsha 410005, China
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