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Ross et al. 1958 See also Anon. 1977 ; . See, for example, Pomerantz and Brown 1997 ; . MacGregor et al. 1956 ; . Crofton 1960 ; . See also Ormerod and Prescott 2003 ; . Medical Research Council Tuberculosis Chemotherapy Trials Committee 1962 ; . Spinaci 1990 ; : 714.
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Vermox side3.7.2 LYMPHOMA B-cell lymphomas represent the second most common neoplasm occurring in HIV-infected patients. These are usually high-grade lymphomas of the large cell type; however, patients with Burkitt's lymphoma and Hodgkin's disease have also been reported. The gastrointestinal tract represents the second commonest site of involvement after the central nervous system. The lymphomas occurring in HIV infection are commonly extranodal. Any part of the gastrointestinal tract can be involved, with the presentation and symptoms depending on the particular site. Systemic symptoms of fevers, night sweats and weight loss are commonly associated. The diagnosis is made by histologic examination of material obtained from endoscopy, or ultrasoundor CT-guided biopsy. Treatment requires combination chemotherapy similar to that for other high-grade lymphomas. Tolerance of therapy is generally poor, often as a result of the poor functional status of these patients when they develop lymphoma and the presence of other opportunistic infections. Full remissions can occur in patients who can tolerate combination chemotherapy, but the prognosis is generally poor. 3.7.3 ANAL CARCINOMA Squamous cell carcinoma of the anal canal is seen with higher frequency in homosexual and bisexual men who practice anoreceptive intercourse. The increased risk is independent of HIV infection and, like cervical carcinoma in women, appears to be related to previous infection with human papilloma virus. Colorectal carcinoma is not seen with higher frequency in this risk group. Anal carcinoma may present with a mass and associated fissure or fistula. Local pain is usually present and there may be bleeding. The differential diagnosis includes infections such as syphilis, lymphogranuloma venereum and condyloma acuminatum, and benign perianal conditions of fissure in ano and anal trauma from intercourse or instrumentation. Definitive diagnosis is made through biopsy of suspicious lesions, especially those that fail to heal after treatment of any secondary infections. Treatment modalities include surgical excision, but many may be treated with combined radiation and chemotherapy, which has effected cures with good preservation of anorectal function and ponstel. 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