Abstract
BackgroundIn this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized.MethodsA total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated.ResultsVesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed.ConclusionsOur findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474
Highlights
In this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized
Kaposi sarcoma (KS) lesions are markedly different in terms of clinical picture and histopathological features, many morphological variants have been defined, e.g., usual [Usual KS (UKS)], anaplastic, telangiectatic, lymphangiectatic, hyperkeratotic, micronodular, keloidal, intravascular, pyogenic granuloma-like [Pyogenic granuloma-like KS (PGLKS)], lymphangiectatic [LKS], lymphangioma-like [Lymphangiom-like KS (LLKS)], etc
All lesions were nodular stage KS lesions and, when epidermal changes were analyzed, hyperkeratosis was detected in 100% of the cases, serum exudation into the keratin layer in 64%, intraepidermal splitting in 84%, subepidermal splitting in16%, ulceration in 10%, papillomatous changes in 10%, and a rise in pigmentation on the basal membrane in 5%
Summary
The clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized. KS lesions are markedly different in terms of clinical picture and histopathological features, many morphological variants have been defined, e.g., usual [UKS], anaplastic, telangiectatic, lymphangiectatic, hyperkeratotic, micronodular, keloidal, intravascular, pyogenic granuloma-like [PGLKS], lymphangiectatic [LKS], lymphangioma-like [LLKS], etc. The evolutionary mechanisms of bullous lesions in KS are still controversial, including whether or not they should be assessed as a different morphological subgroup [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]
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