Kaposi sarkomunda gastrik tutulum ve Helicobacter pylori

Abstract

Giris ve Amac: Kaposi sarkom siklikla cilt bulgulari ile ortaya cikar. Gast- rointestinal sistem nadiren tutuldugu icin endoskopistler gastrik lezyonlara asina degildir. Bu calismada klasik Kaposi sarkomu ve kazanilmis immun yetmezlik sendromu iliskili Kaposi sarkomu olgularimizi gastrik semptomlar, gastrik tutulum ve Helicobacter pylori enfeksiyonu birlikteligi acisindan de- gerlendirmeyi amacladik. Gerec ve Yontem: Kaposi sarkomu tanisi ile takip edilen 18 olgu calismaya dahil edildi. Kontrol grubu olarak poliklinige basvu- ran ve Helicobacter pylori acisindan test edilen 40 olgu calismaya dahil edildi. Kaposi sarkomlu tum olgularin evreleri, aldiklari tedaviler, cilt ve oral muaye- nesi kaydedildi. Olgularin gastrik yakinmalarinin olup olmadigi sorgulandi. Tum olgulara gastroduodenoskopi yapildi. Histopatolojik olarak gastrik tutu- Background and Aims: Kaposi's sarcoma usually presents as skin lesions. Since the gastrointestinal tract is rarely involved in Kaposi's sarcoma patients, endoscopists are not familiar with gastric lesions. In the present study, we aimed to evaluate patients with classical Kaposi's sarcoma and acquired im- munodeficiency syndrome -associated Kaposi's sarcoma with respect to gas- tric symptoms, gastric involvement, and the presence of Helicobacter pylori. Materials and Methods: This study included 18 patients with Kaposi's sar- coma. Forty patients, admitted to the outpatient clinic for Helicobacter pylori, were included as the control group. Stage of the disease, therapy, and der- matological and oral examination findings were recorded. All patients were questioned regarding gastric symptoms and underwent upper gastrointesti- nal endoscopy. Biopsies were taken from areas suspected as having Kaposi's sarcoma involvement and from the corpus and antrum for the presence of Helicobacter pylori, and results were compared with the control group. Re- sults: Among the 18 patients included in the study, 17 (94.4%) of them were male, and the mean age of the patients was 59.3 (39-79) years. Fif- teen patients (83.3%) had classical Kaposi's sarcoma, while 3 (16.7%) had acquired immunodeficiency syndrome -associated Kaposi's sarcoma. Of the 5 patients suspected of having Kaposi's sarcoma on upper gastrointestinal endoscopy, the diagnosis of Kaposi's sarcoma was verified in 3 patients his- topathologically. The fundus and corpus were involved in 2 patients and the antrum in 1 patient. None of the biopsies taken from areas other than gas- tric lesions had any findings associated with Kaposi's sarcoma. In general, 10 patients (55.6%) were symptomatic. Two of 3 (66.6%) patients with gastric involvement and 8 of 15 (55.3%) patients without gastric involvement were symptomatic. Helicobacter pylori was positive in 66.6% of all patients with Kaposi's sarcoma and in 52.5% of patients in the control group (p=0.206). Two patients with Kaposi's sarcoma and gastric involvement were positive for Helicobacter pylori, and these patients had oral involvement as well as ac- quired immunodeficiency syndrome -associated Kaposi's sarcoma, and they were younger. Conclusions: Presence of gastric symptoms was not enough to assume gastric involvement in Kaposi's sarcoma patients. Gastric involve- ment is more frequent in patients with oral involvement and in those with acquired immunodeficiency syndrome -associated Kaposi's sarcoma. There was no difference between patients with and without Kaposi's sarcoma in terms of Helicobacter pylori positivity.