More than 40 per cent cases of the acquired immunodeficiency syndrome (AIDS) have the risk of developing cancer. The risk of cancer increases as the survival of the HIV infected patient prolongs. Genesis of cancer in the HIV infected patient is known as AIDS-defining event. The AIDS-related cancers include Kaposi's sarcoma, non-Hodgkin's lymphoma in AIDS and carcinoma of the cervix & the anus. Studies have revealed that there is a much higher incidence of cervical cancer in HIV infected women. Similarly, the incidence of anal cancer is much higher in HIV infected men. It appears that infection of human papillomavirus in AIDS patients is the main cause of cancer rather than the immunodeficiency.
Kaposi's Sarcoma in AIDS
Kaposi's sarcoma was first described by Moritz Kaposi in 1872. It remained a rare tumour until its rising incidence was found in the AIDS patients. Kaposi's sarcoma in AIDS is a highly malignant tumour. It usually presents with multiple skin lesions along the skin flexures. The lesions of Kaposi's sarcoma in AIDS may be flat or raised with well-circumscribed margins and are red or violet in colour. These lesions are usually found in the mouth, hard palate and tip of the nose. Kaposi's sarcoma in AIDS may present as a bulky lesion in the lower extremity accompanied by oedema, pain and bleeding. Kaposi's sarcoma in AIDS usually involves the lymph nodes and the internal organs such as the lungs and the stomach. There may be enlargement of the liver and the spleen. Involvement of the stomach and the rectum may lead to intestinal obstruction, whereas the involvement of the lungs may lead to cough, breathlessness and pleural effusion. The infection with a virus of herpes family is the major cause of Kaposi's sarcoma in AIDS.
Non-Hodgkin's Lymphoma in AIDS
Non-Hodgkin's lymphoma in AIDS is a highly malignant tumour. In about 80 per cent cases of the non-Hodgkin's lymphoma in AIDS, the tumour arises from B-lymphocytes, and in the remaining 20 per cent of the cases, it arises from the T-lymphocytes. Non-Hodgkin's lymphoma in AIDS usually involves extranodal sites such as the gastrointestinal tract, central nervous system, bone marrow and the liver.
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