Kaposi's sarcoma-associated herpesvirus-like DNA sequences in multicentric Castleman's disease [see comments]

Multicentric Castleman's disease (MCD) is an atypical lymphoproliferative disorder defined using clinical and pathologic criteria. A characteristic of the MCD is a close association with Kaposi's sarcoma (KS), which occurs during the clinical course of most human immunodeficiency virus (HIV)-associated MCD cases and also, but less frequently, in HIV-negative patients. Recently, sequences of a putative new Herpesvirus (KSHV) have been isolated and further detected in almost all the acquired immunodeficiency syndrome (AIDS) KS and in most of the non-AIDS KS samples. In this study, we searched for these Herpesvirus-like sequences in MCD samples of 31 patients. KSHV sequences were detected in 14 of 14 cases of HIV-associated MCD, including 5 cases without detectable KS. Moreover, KSHV was detected in 7 of 17 MCD cases in HIV-negative patients, including 1 case associated with a cutaneous KS. In 34 non-MCD reactive lymph nodes (follicular and/or interfollicular hyperplasia) in HIV-negative patients, KSHV was detected in only 1 case. In 1 HIV-negative case of MCD, KSHV was found in both the lymph node and peripheral blood samples. These data suggest that KSHV could play a role in the pathogenesis of MCD, especially in HIV-infected patients.     

Treatment of postenucleation orbital cysts

Conjunctival cysts of the orbit may be an early or late sequela of enucleation. The most frequent presentation is the inability to retain the external prosthesis. Treatment by excision, marsupialization, or injection of absolute alcohol (95% ethanol) is discussed. Injection of absolute alcohol is advocated because no additional surgical procedure is required. Postulated mechanisms include conjunctival implantation, incarceration, and dehiscence with epithelial downgrowth.