KAPOSI'S HAEMANGIOSARCOMA AS SEEN IN CENTRAL AFRICA. THE ROLE OF RADIOLOGY.

Abstract

SummaryThe author briefly traces the history of Kaposi's haemangiosarcoma from its first description in 1872 to date, and presents evidence that the incidence, virulence and over‐all clinical picture of this entity vary considerably in different regions of Africa, while the histologic findings and the radio graphic changes, particularly in the bones,do not differ.The author finds that the two primary clinical features in adults are the nodule and the oedema, while the general health of the patient is rarely affected until the late stages. He describes the disease in children as affecting the glands, with virtual absence of oedema and presence of only a few skin nodules, and as a cute, severe and often rapidly fatal. The symptoms and signs seen in both adults and children are discussed in detail. The histology of the disease, including its three stages, the inflammatory, the granulomatous and the neoplastic, is described. The importance of differential diagnosis,particularly to distinguish Kaposi's haemangiosarcoma from maduramycosis and leprosy, is stressed.The author discusses the important role of radiology in both the diagnostic work‐up of the patient and his treatment. He advocates soft tissue x‐ray films, especially to demonstrate the presence of subcutaneous or deep lesions in cases with solitary skin nodules as well as the use of arteriography, chest plates, and x‐rays to demonstrate skeletal changes as evidence of widespread disease. He emphasizes the need for improving the radiographic technique to visualize the alimentary tract, and considers pyelography of no value. Properly applied conventional deep x‐ray therapy, Cobalt 60 or other supervoltage therapy will yield highly satisfactory results; Cobalt 60 teletherapy is recommended for bone cysts.In the author's experience, the various cytotoxic drugs have proved disappointing; surgery should be limited to the treatment of isolated lesions and certain sites, such as the conjunctivae.