Epstein-Barr Virus Infection-Associated Smooth-Muscle Tumors in Patients with AIDS

Suankratay, Chusana; Shuangshoti, Shanop; Mutirangura, Apiwat; Prasanthai, Vichit; Lerdlum, Sukalya; Shuangshoti, Samruay; Pintong, Jarupan; Wilde, Henry

doi:10.1086/429830

Cited by 90 publications

(151 citation statements)

References 32 publications

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“…Some studies have reported an association with HIV infection and the Epstein-Barr virus infection, and the possibility of a viral infection etiology has been suggested [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Aoki¹,

Tanaka²,

Suzuki³

et al. 2017

J Clin Case Rep

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Primary adrenal leiomyosarcoma is an extremely rare tumor. Here, we report the case of a primary adrenal leiomyosarcoma in an 81-year-old woman. Computed tomography showed a right adrenal tumor (7 cm). There were no abnormal findings on physical examination and her serum adrenal hormone levels were normal. However, 67Gallium scintigraphy showed gallium accumulation at the site of a right adrenal tumor, and malignancy was suspected. The right adrenal tumor was surgically removed and histological examination revealed that it was a leiomyosarcoma. After surgical treatment, the patient was administered different types of chemotherapy but she died of local recurrence 1 year later.

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“…Some studies have reported an association with HIV infection and the Epstein-Barr virus infection, and the possibility of a viral infection etiology has been suggested [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Aoki¹,

Tanaka²,

Suzuki³

et al. 2017

J Clin Case Rep

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“…Iris leiomyosarcoma is an extremely rare malignant tumor [4][5][6]. It arises from the dilator and sphincter muscles, which are of neuroectoderm in origin.…”

Section: Commentmentioning

confidence: 99%

“…It arises from the dilator and sphincter muscles, which are of neuroectoderm in origin. Ebstein-Barr virus has been intimately associated, though not necessarily in a causal fashion, with multiple malignancies in AIDS including Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's disease, B-cell lymphomas [1], and leiomyosarcoma [4,5,7,8]. Although intraocular leiomyosarcoma has a potential to spread locally, it rarely metastasizes to distant organs resulting in an excellent survival prognosis [9].…”

Section: Commentmentioning

confidence: 99%

Ebstein-Barr Virus-Associated Iris Leiomyosarcoma in an AIDS Patient : A Case Report

Rojnaporn¹

2014

J Clin Exp Ophthalmol

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Importance: Report of an AIDS patient with Ebstein-Barr virus (EBV)-associated iris leiomyosarcoma. Observations:A 19-year-old AIDS patient presented with a painless rapidly growing mass in the right iris. EBVassociated leiomyosarcoma was confirmed by an immunohistochemical study of the excisional biopsy. Conclusion:This is the second case report on immunohistochemically proven EBV-associated iris leiomyosarcoma in AIDS.

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“…The most frequently reported EBV-associated malignancies are Burkitt lymphoma, Hodgkin lymphoma, post-transplant lymphoproliferative disorder (PTLD), and nasopharyngeal carcinoma (1)(2)(3)(4). Recently, the strong relation of EBV to the development of smooth muscle tumors (SMTs) in immunocompromised patients has been increasingly recognized, mainly in post-transplantation and AIDS patients (5,6). EBV-SMTs are rare neoplasms, with less than 30 cases reported in post solid organ transplantation pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

“…EBV-SMTs are rare neoplasms, with less than 30 cases reported in post solid organ transplantation pediatric patients. They are usually multicentric and exhibit a predilection to occur in sites that are unusual for conventional SMTs, most commonly the liver and lung (5,6).…”

Section: Introductionmentioning

confidence: 99%

EBV-associated hepatic smooth muscle tumor of uncertain biologic behavior after heart transplantation in a pediatric patient: case report

Liu

Chintalapati

Dietz

et al. 2017

J. Gastrointest. Oncol.

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Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is a rare neoplasm recognized in immunocompromised patients. There are less than 30 cases of EBV-SMT reported in pediatric population following solid organ transplantation. Herein, we report a case of an 8-year-old female who was incidentally noted to have multiple lesions in the liver 8 years after heart transplantation. The tumor was composed of a cellular proliferation of spindle-shaped cells with low mitotic activity. The diagnosis of EBV-SMT was confirmed by in situ hybridization for EBV-encoded small RNA (EBER) transcripts. Multiple additional lesions were detected by whole body positron emission tomography-computed tomography (PET-CT) scan 4 months after the initial finding of the hepatic lesions. Immunosuppression was switched to a mechanistic target of rapamycin (mTOR) inhibitor. We conclude that EBV-SMT should be included in the differential diagnoses in post-transplantation patients and further investigations should be performed to evaluate additional lesions. transplantation. Serial testing for EBV DNA by quantitative polymerase chain reaction (PCR) was performed on peripheral blood starting 3 years after the heart transplant (she presented with cough and fever), which showed amplification with up to 131,600 copies/mL. Her EBV viral load has been consistent since then. She developed acute abdominal pain and an appendiceal perforation was diagnosed 8 years post-transplant. Two liver masses were incidentally identified in the left and right hepatic lobes by abdominal computed tomography (CT) scan. Both appeared hypoechoic and individually measured up to 2.5 cm. Whole body positron emission tomography (PET)-CT scan was performed thereafter with no evidence of lymphadenopathy or other lesions. The mass in the right lobe was excised and found to be well circumscribed, white, and firm on gross examination. The mass in the left lobe was not removed due to its deep location. KeywordsHistologically, the hepatic lesion was well demarcated from the adjacent liver parenchyma, and exhibited interlacing fascicles of spindle cells with eosinophilic cytoplasm and elongated, blunt-ended nuclei with stippled chromatin (Figure 1). Rare (less than 5%) primitive round cell component was identified. There was no evidence of necrosis or hemorrhage. Few small blood vessels were interspersed within the fascicles of spindle cells. Mitotic activity was less than 1 per 10 high power fields (HPF). Occasional lymphoid cells were seen at the junction between the tumor and adjacent liver parenchyma (Figure 2). Immunohistochemical (IHC) stains were performed to categorize the lesion. Smooth muscle actin ( Figure 3A) and HHF 35 ( Figure 3B) were positive, and desmin showed focal and weak equivocal staining consistent with smooth muscle origin. Ki67 showed only 1-2% of proliferative activity. EBV in situ hybridization was positive with a diffuse staining pattern (Figure 4), diagnostic of EBV infection. All these features were consistent with a diagnosis of EBV-SMT.W...

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Epstein-Barr Virus Infection-Associated Smooth-Muscle Tumors in Patients with AIDS

Cited by 90 publications

References 32 publications

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Ebstein-Barr Virus-Associated Iris Leiomyosarcoma in an AIDS Patient : A Case Report

EBV-associated hepatic smooth muscle tumor of uncertain biologic behavior after heart transplantation in a pediatric patient: case report

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