June 21, 1985

Simultaneous Occurrence of Pneumocystis carinii Pneumonia, Cytomegalovirus Infection, Kaposi's Sarcoma, and B-Immunoblastic Sarcoma in a Homosexual Man

Author Affiliations

From the Department of Internal Medicine, Division of Hematology (Drs Burkes, Stewart, Gill, Abo, and Levine), and the Department of Pathology, Division of Hematopathology (Dr Gal), Los Angeles County-University of Southern California Medical Center, Los Angeles; and the Kenneth Norris Jr Cancer Hospital and Research Institute, University of Southern California School of Medicine, Los Angeles (Dr Levine).

JAMA. 1985;253(23):3425-3428. doi:10.1001/jama.1985.03350470077024

The most common manifestations of the acquired immunodeficiency syndrome include Pneumocystis carinii pneumonia and/or Kaposi's sarcoma. High-grade B-cell lymphomas have also been reported in homosexual men at risk for the acquired immunodeficiency syndrome. We herein present the case of a homosexual man, who presented simultaneously with Pneumocystis carinii pneumonia, acute cytomegalovirus infection, Kaposi's sarcoma, and B-cell immunoblastic sarcoma. Severe compromise of both the B- and T-cell arms of the immune system was documented. The patient had evidence of exposure to the human T-lymphotropic retrovirus III, evidence of reactivation of Epstein-Barr virus infection, and cytomegalovirus inclusions within Kaposi's sarcoma tissue. We conclude that exposure to these viral agents in the setting of severe immunocompromise may have led to the observed "opportunistic" neoplasms.

(JAMA 1985;253:3425-3428)