Anatomia Patologia

Non-Hodgkin lymphoma of the B-cell type is the second most common neoplasm in patients with human immunodeficiency virus infection after Kaposi's sarcoma. The majority of the cases of non-Hodgkin lymphoma associated with the acquired immunodeficiency syndrome involve extranodal sites, specially the digestive tract, including the oral cavity and the central nervous system. The estimated relative risk of NHL associated HIV infection is 100 times greater than in general population and this risk increases with the progressive immunosuppression related to the retrovirus Burkitt's lymphoma has frequently been reported as a neoplasm in HIV infected patients. These lymphomas are now better designed as AIDS-related BL.

Kaposi´s Sarcoma (KS) is polyclonal multifocal disease of endothelial origin, with four clinical and epidemiological well described variants. AIDS-related KS has a variable clinical course, ranging from minimal disease located to the skin and presenting as an incidental finding to a rapidly progressing neoplasm with skin, mucosal, and visceral compromise that can result in significant morbidity and mortality, depending upon the specific sites of involvement. Bacillary Angiomatosis (BA) is a rare manifestation of infection caused by Bartonella species, which leads to vasoproliferative lesions of skin and other organs. Bacillary angiomatosis affects individuals with advanced HIV disease or other immune compromised individuals. There are two conceptually distinct Bartonella-associated syndromes: bacteremia (in the absence of focal tissue vascular proliferative response) and the tissue infection associated with angiogenic response. A major challenge in the diagnosis of cutaneous BA is the diverse presentation of lesions. The most important clinical differential diagnosis of cutaneous lesions includes KS. Here, we present an HIV/AIDS patient that developed concomitant KS and BA in the same skin lesion diagnosis by histopathological examination of biopsy sample and biomolecular diagnosis methods.

Malignant glioma is the most common primary brain neoplasm. Generally, gliomas are not included in the differential diagnosis of enhancing lesions of the central nervous system in patients infected by the human immunodeficiency virus. We report a case of gliosarcoma in a patient with AIDS presenting as a single cerebral lesion. Stereotactic brain biopsy was obtained and definitive histopathological diagnosis of gliosarcoma was made. A decline in the incidence of opportunistic infections associated with highly active antiretroviral therapy suggest the importance of early stereotactic biopsy to confirm the diagnosis of these neoplasms.