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Correspondence |

Disseminated Cutaneous Kaposi Sarcoma and Progressive Multifocal Leukoencephalopathy in a Patient With Idiopathic CD4+ T Lymphocytopenia

Oliver Inhoff, MD; Kristina Doerries, PhD; Ruediger Doerries, PhD; Johann Scharf, MD; Christoph Groden, MD; Sergij Goerdt, MD; Dirk Schadendorf, MD
Arch Dermatol. 2007;143(5):659-675. doi:10.1001/archderm.143.5.673.
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Centers for Disease Control and Prevention, Update: CD4+ T-lymphocytopenia in persons without evident HIV infection–United States. MMWR Morb Mortal Wkly Rep 1992;41578- 579
Dörries  KSbiera  SDrews  KArendt  GEggers  CDorries  R Association of human polyomavirus JC with peripheral blood of immunoimpaired and healthy individuals. J Neurovirol 2003;9 ((suppl 1)) 81- 87
PubMed Link to Article[[XSLOpenURL/10.1080/13550280390195379]]
Wu  HMitra  DMesri  ELaurence  JHuman herpesviruses-8 (HHV-8)-mediated CD4+ T-lymphocytopenia http://www.aegis.com/aidsline/1998/jun/M9860495.htmlAccessed July 2, 2006
Berger  JRMajor  EO Progressive multifocal leukoencephalopathy. Semin Neurol 1999;19193- 200
PubMed Link to Article[[XSLOpenURL/10.1055/s-2008-1040837]]
Haider  SNafziger  DGutierrez  JABrar  IMateo  NFogle  J Progressive multifocal leukoencephalopathy and idiopathic CD4+lymphocytopenia: a case report and review of reported cases. Clin Infect Dis 2000;31E20- E22
PubMed Link to Article[[XSLOpenURL/10.1086/cid.2000.31.issue-4]]
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Clinical (A and B), histologic (C), and magnetic resonance imaging (MRI) (D-G) findings. A and B, Disseminated cutaneous Kaposi sarcoma lesions on the lower leg appear as reddish to purple papules and plaques, partly hyperkeratotic and partly hemorrhagic. C, Within the dermis, a vascular proliferation with some nodular and some cordal characteristics is seen. Between the numerous extravasated erythrocytes and medium-sized epithelioid cells with eosinophilic cytoplasm, large oval nuclei with faint nucleoli are seen. Occasionally mitotic figures are present. In addition to the regular capillary vessels, irregular vascular channels surround a preexisting vessel (promontory sign) (hematoxylin-eosin, original magnification ×20). D-G, Fast-progressing progressive multifocal leukoencephalopathy visualized by MRI: D and E, Lesions are seen in the left frontal lobe (arrows) in fluid-attenuated inversion recovery (FLAIR) (D) and T1-weighted (E) images after the administration of contrast material without parenchymal enhancement; slightly transient, pronounced meningeal enhancement is seen after lumbar puncture. F, axial MRI slides in FLAIR show typical T2-intense lesions in the middle cerebral peduncle, second neurone of the corticopontocerebellar tract (arrow), and pons. G, In this region, the lesions had clearly progressed from October to November 2004.

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