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  • 1
    Language: English
    In: Archives of pathology & laboratory medicine, March 2012, Vol.136(3), pp.316-23
    Description: Human immunodeficiency virus (HIV) infection is rife in sub-Saharan Africa and in southern Africa in particular. Despite the increasing availability of antiretroviral therapy in this region, HIV-associated neoplasms remain common and frequently involve the gastrointestinal tract, which may also demonstrate other noninfectious, HIV-related pathology. To review the histopathologic findings and distinguishing features of neoplastic and noninfectious, HIV-associated gastrointestinal disorders in southern Africa and relate those findings to the documented international literature. The available literature on this topic was reviewed and supplemented with personal experience in a private histopathology practice in South Africa. In southern Africa, a diverse range of HIV-related neoplasms and noninfectious gastrointestinal disorders is seen, but published data for the region are scarce. The gastrointestinal disorders include drug-associated pathology, gastrointestinal manifestations of the immune reconstitution inflammatory syndrome, idiopathic chronic esophageal ulceration, and the controversial entity of HIV enteropathy.
    Keywords: AIDS-Related Opportunistic Infections -- Complications ; Acquired Immunodeficiency Syndrome -- Complications ; Gastrointestinal Neoplasms -- Complications ; Gastrointestinal Tract -- Pathology
    E-ISSN: 1543-2165
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  • 2
    Language: English
    In: The Journal of infectious diseases, 01 October 2013, Vol.208(7), pp.1113-22
    Description: Human immunodeficiency virus type 1 (HIV-1) infection is associated with a massive depletion of intestinal CD4(+) T cells that is only partially reversed by combination antiretroviral therapy (cART). Here, we assessed the ability of nucleoside reverse-transcriptase inhibitor/nonnucleoside reverse-transcriptase inhibitor treatment to restore the CD4(+) T-cell populations in the intestine of South African patients with AIDS. Thirty-eight patients with advanced HIV-1 infection who had chronic diarrhea (duration, 〉4 weeks) and/or unintentional weight loss (〉10% decrease from baseline) of uncertain etiology were enrolled. Blood specimens were collected monthly, and gastrointestinal tract biopsy specimens were collected before cART initiation (from the duodenum, jejunum, ileum, and colon), 3 months after cART initiation (from the duodenum), and 6 months after cART initiation (from the duodenum and colon). CD4(+), CD8(+), and CD38(+)CD8(+) T cells were quantified by flow cytometry and immunohistochemistry analyses, and the HIV-1 RNA load was determined by the Nuclisens assay. CD4(+) T-cell and HIV-1 RNA levels were significantly lower, whereas CD8(+) T-cell levels, including activated CD38(+)CD8(+) T cell levels, were higher in the duodenum and jejunum, compared with the colon. After 6 months of cART, a significant but incomplete recovery of CD4(+) T cells was detected in the colon and peripheral blood but not in the duodenum. Failed restoration of the CD4(+) T-cell count in the duodenum was associated with nonspecific enteritis and CD8(+) T-cell activation. Strategies that target inflammation and immune activation in the small intestine may be required to expedite CD4(+) T-cell recovery and improve therapeutic outcomes.
    Keywords: Africa ; Cd4 Reconstitution ; HIV-1 ; Antiretroviral Therapy ; Immune Activation ; Intestine ; Anti-Retroviral Agents -- Therapeutic Use ; Cd4-Positive T-Lymphocytes -- Immunology ; HIV Infections -- Drug Therapy ; Intestinal Mucosa -- Immunology ; Intestine, Large -- Immunology ; Intestine, Small -- Immunology
    ISSN: 00221899
    E-ISSN: 1537-6613
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  • 3
    Language: English
    In: Virchows Archiv, 2018, Vol.473(1), pp.121-125
    Description: Thymoma-associated multiorgan autoimmunity (TAMA) is a recently delineated and rare paraneoplastic syndrome reported in patients with thymoma. The disorder is characterized by graft-versus-host disease-like pathology affecting the skin, gastrointestinal tract (GIT), and liver, and is usually associated with a poor outcome. We document a case of TAMA with exclusive GIT involvement which included the stomach, small and large bowel, presenting in a 66-year-old male patient 5 years after complete resection of a type B2 thymoma. A brief review is provided of this scarce syndrome, the GIT pathology described in the 21 TAMA cases reported to date, and the unique characteristics of patients with exclusive GIT involvement by this acquired autoimmune disorder.
    Keywords: Thymoma-associated multiorgan autoimmunity ; Graft-versus-host disease-like gastroenterocolitis ; Paraneoplastic syndrome ; Secondary autoimmune enteropathy
    ISSN: 0945-6317
    E-ISSN: 1432-2307
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  • 4
    Language: English
    In: Virchows Archiv, 2018, Vol.472(1), pp.135-147
    Description: International travels and global human migration have had the unforeseen consequence of increasing the exposure of histopathologists in developed countries to the pathology of tropical infectious disease. The gastrointestinal tract (GIT) is often the primary site of infection due to the faecal-oral route of transmission and the high risk of exposure to contaminated water, food or soil when travelling to these regions. Whilst current microbiologic techniques are far more sensitive than histology in detecting infectious pathogens, the histopathologist nonetheless retains a pivotal role in diagnosing tropical GIT disease. This role entails evaluating endoscopic biopsies for any characteristic inflammatory pattern, identifying pathogens which may be present and excluding other look-alike pathologies. Recent advances in commercially available diagnostic modalities, including molecular techniques, have further broadened the scope of the histopathologist’s armamentarium. This review outlines a practical pattern-based approach to diagnosing tropical GIT infections in endoscopic material, so as to assist pathologists less familiar with this spectrum of pathology.
    Keywords: Gastrointestinal tract ; Tropical infections ; Histopathology ; Patterns
    ISSN: 0945-6317
    E-ISSN: 1432-2307
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  • 5
    Article
    Article
    BMJ Publishing Group Ltd and Association of Clinical Pathologists
    Language: English
    In: Journal of Clinical Pathology, 8 October 2014, Vol.67(10), p.891
    Description: Cronkhite–Canada syndrome is a rare gastro-entero-colopathy of uncertain aetiology first described almost 60 years ago. It is characterised by diffuse gastrointestinal polyposis sparing only the oesophagus, ectodermal abnormalities and an unpredictable but often fatal clinical course. The disease may demonstrate extremely diverse clinical and endoscopic features, which often leads to a delay in diagnosis. A high index of suspicion and recognition of the characteristic histological findings frequently facilitate a correct diagnosis, but the distribution of the gastrointestinal pathology and its microscopic features may be atypical. The pathologist thus requires a thorough knowledge of both the typical and many atypical faces of this disease, for which various documented therapies often still prove ineffective. Close correlation with clinical findings, including any pertinent ectodermal abnormalities, and careful examination of biopsies derived from polypoid and endoscopically spared mucosa will ensure a timely and correct diagnosis in patients with this enigmatic syndrome.
    Keywords: Gastroenterology ; Gastrointestinal Disease ; Gut Pathology
    ISSN: 0021-9746
    ISSN: 00219746
    E-ISSN: 1472-4146
    E-ISSN: 14724146
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  • 6
    Language: English
    In: Journal of clinical pathology, October 2014, Vol.67(10), pp.891-7
    Description: Cronkhite–Canada syndrome is a rare gastro-enterocolopathy of uncertain aetiology first described almost 60 years ago. It is characterised by diffuse gastrointestinal polyposis sparing only the oesophagus, ectodermal abnormalities and an unpredictable but often fatal clinical course. The disease may demonstrate extremely diverse clinical and endoscopic features, which often leads to a delay in diagnosis. A high index of suspicion and recognition of the characteristic histological findings frequently facilitate a correct diagnosis, but the distribution of the gastrointestinal pathology and its microscopic features may be atypical. The pathologist thus requires a thorough knowledge of both the typical and many atypical faces of this disease, for which various documented therapies often still prove ineffective. Close correlation with clinical findings, including any pertinent ectodermal abnormalities, and careful examination of biopsies derived from polypoid and endoscopically spared mucosa will ensure a timely and correct diagnosis in patients with this enigmatic syndrome.
    Keywords: Intestinal Mucosa -- Pathology ; Intestinal Polyposis -- Pathology ; Intestinal Polyps -- Pathology ; Stomach -- Pathology
    E-ISSN: 1472-4146
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 7
    In: Journal of Cutaneous Pathology, May 2007, Vol.34(5), pp.427-430
    Description: Heterologous differentiation is exceedingly rare in melanoma. Only four cases of melanoma demonstrating exclusive cartilaginous differentiation have been documented, all having occurred on the lower extremity. We report a chondroid melanoma involving the nasal skin and presenting clinically as a basal cell carcinoma. Both Melan‐A and microphthalmia transcription factor protein immunoperoxidase stains were positive in our case, demonstrating the potential utility of these two stains in chondroid melanoma. We also provide a succinct review of the literature on this rare melanoma variant.
    Keywords: Melanoma;
    ISSN: 0303-6987
    E-ISSN: 1600-0560
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  • 8
    Language: English
    In: Child's Nervous System, 2011, Vol.27(2), pp.323-326
    Description: Includes references ; p. 323-326.
    Keywords: Cell Differentiation–Pathology ; Child, Preschool–Surgery ; Craniopharyngioma–Pathology ; Diagnosis, Differential–Surgery ; Humans–Pathology ; Pituitary Neoplasms–Pathology ; Teratoma–Pathology ; Tooth–Pathology;
    ISSN: 0256-7040
    E-ISSN: 1433-0350
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  • 9
    In: Pancreas, 2014, Vol.43(3), pp.482-483
    Keywords: Anoctamin-1–Metabolism ; Antigens, Cd34–Metabolism ; Chloride Channels–Metabolism ; Chromogranin A–Diagnosis ; Diagnosis, Differential–Metabolism ; Duodenal Neoplasms–Metabolism ; Epithelioid Cells–Pathology ; Female–Diagnosis ; Gastrointestinal Stromal Tumors–Metabolism ; Humans–Metabolism ; Middle Aged–Diagnosis ; Neoplasm Proteins–Metabolism ; Neuroendocrine Tumors–Metabolism ; Neurons–Pathology ; Pancreatic Neoplasms–Diagnosis ; Proto-Oncogene Proteins C-Kit–Metabolism ; Proto-Oncogene Proteins C-Kit–Metabolism ; Ano1 Protein, Human ; Anoctamin-1 ; Antigens, Cd34 ; Chloride Channels ; Chromogranin A ; Neoplasm Proteins ; Proto-Oncogene Proteins C-Kit;
    ISSN: 0885-3177
    E-ISSN: 15364828
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  • 10
    Language: English
    In: Journal of Hematopathology, 2015, Vol.8(1), pp.3-11
    Description: High-grade non-Hodgkin’s lymphomas with plasmablastic differentiation are frequently encountered in HIV-positive patients. Differentiating between diffuse large B cell lymphoma (DLBCL) with plasmablastic differentiation and true cases of plasmablastic lymphoma (PBL) is sometimes challenging, particularly as a substantial overlap in immunphenotype exists between late-stage B cell neoplasms and PBL. This study sought to develop an immunohistochemical panel to more reliably distinguishing between PBL and DLBCL with plasmablastic differentiation. Thirty-nine CD20-negative, ALK-negative, HHV8-negative non-Hodgkin’s lymphomas with plasmablastic differentiation defined by their morphological features, high proliferation index and positivity for MUM1/IRF4 and PRDM/Blimp1 protein expression were compared regarding their protein expression profiles, viral status and c-MYC-gene aberrations. These lymphomas were subsequently divided in two groups utilising CD10 and Pax5. Tumours without reactivity for either of these markers exhibited higher expression of CD138 and CD117 frequently used as the plasma cell (PC) markers, whilst tumours with reactivity for one or both markers showed a significantly higher expression of CD38 and MYC-gene aberrations. A novel diagnostic scoring system which includes the immunohistochemical expression of CD10 and Pax5 is proposed to differentiate between DLBCL with plasmablastic differentiation and true cases of PBL.
    Keywords: Plasmablastic lymphoma ; Diffuse large B cell lymphoma ; Plasmablastic differentiation ; Diagnostic scoring ; HIV
    ISSN: 1868-9256
    E-ISSN: 1865-5785
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