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Int J Clin Exp Pathol 2011;4(4):421-429

Case Report
Multicentric hepatic EBV-associated smooth muscle tumors in an AIDS patient: a case
report, investigation of mTOR activation and review of the literature

Qi Shen, Wei Feng, Michael S. Long, Xiuzhen Duan, Siraya Jaijakul, Cesar A. Arias, Robert E. Brown, Bihong Zhao

Department of Pathology and Laboratory Medicine, The University of Texas Medical School at Houston, Houston TX, USA. North Cypress
Medical Center, Cypress TX, USA; Division of Infectious Diseases, Department of Internal Medicine, The University of Texas Medical School at
Houston, Houston TX, USA.

Received April 10, 2011; accepted April 19, 2011; Epub April 23, 2011; published April 30, 2011

Abstract: Epstein-Barr virus (EBV) - associated smooth muscle tumors (EBV-SMT) are a rare, recently recognized distinct group of
mesenchymal tumors that develop exclusively in patients with immunosuppression.  It is believed that tumorigenesis is, at least in part,
through the activation of the Akt/mammalian target of rapamycin (mTOR) signal pathway.  We describe the clinicopathologic and
immunohistochemical features of a multifocal hepatic EBV-SMT in a 34-year-old acquired immunodeficiency syndrome (AIDS) patient and
investigate the activation status of the mTOR signal pathway in this tumor. In addition, we provide a review of the literature on the
clinicopathologic findings of hepatic EBV-SMT in adult AIDS patients, and discuss their biologies and possible therapeutic strategies.   

Keywords: Smooth muscle tumor, HIV infection, acquired immunodeficiency syndrome, adult, Epstein-Barr virus, liver

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Address all correspondence to:
Bihong Zhao, MD, PhD
Department of Pathology & Laboratory Medicine
The University of Texas Medical School at Houston
6431 Fannin Street, MSB-2.274
Houston TX, 77030, USA.
Tel: (713) 500-5349; Fax: (713) 500-0733