RESUMEN
Six patients with Hodgkin's disease (HD) and demonstrable serum antibodies to human immunodeficiency virus (HIV) and two additional patients with HD belonging to HIV-associated high-risk groups but with negative HIV serology were studied. All patients were men and ranged in age from 21 to 45 years. The HIV risk factors included homosexuality (6), intravenous drug abuse (2), and hemophilia A (1). All patients had high pathologically determined stage (one Stage III and seven Stage IV), and bone marrow involvement was observed in five patients with the initial diagnosis of HD based on marrow biopsy in two cases. Four cases were histologically subclassified as mixed cellularity (MC) and three as nodular sclerosis (NS); one patient underwent only bone marrow biopsy and was not subclassified. Histologically all cases were characterized by numerous Reed-Sternberg cells and variants, and with the exception of one case, all had a distinctive decrease in the proportion of reactive background lymphocytes compared with what is usually expected in MC or NS Hodgkin's disease (relative lymphocyte depletion). Flow-cytometric immunophenotypic studies done on cell suspensions from diagnostic lymph node biopsies in four cases showed decreased CD4:CD8 ratios (mean = 1.4) compared with expected values of 4 to 6. The relative lymphocyte depletion observed histologically is probably a reflection of the decreased tissue CD4:CD8 ratios, and this impairment of host immune response may be related to the observed high stage in all eight cases. Patients with high stage HD and the described histologic and immunologic features should be evaluated for the presence of HIV infection.
Asunto(s)
Infecciones por VIH/complicaciones , Enfermedad de Hodgkin/etiología , Adulto , Antígenos de Diferenciación/análisis , Médula Ósea/patología , Citometría de Flujo , Infecciones por VIH/diagnóstico , Seropositividad para VIH , Enfermedad de Hodgkin/inmunología , Enfermedad de Hodgkin/patología , Humanos , Técnicas para Inmunoenzimas , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de NeoplasiasRESUMEN
Two cases of rectal polyps that showed foci of squamous metaplasia are reported. In one, the squamous metaplasia was observed in an area of intramucosal adenocarcinoma. This finding tends to reinforce the contention previously made by some authors that squamous metaplasia in colorectal polyps may represent the precursor of primary colorectal squamous cell carcinoma or colorectal adenocarcinoma with squamous components (adenoacanthoma or adenosquamous carcinoma).