Pyogenic granuloma-like Kaposi sarcoma: Case report and review of literature

Effat Omar,Mardiana Abdul Aziz

doi:10.24191/jchs.v5i2.11124

Abstract

Pyogenic granuloma-like Kaposi sarcoma (PGLKS) is an uncommon variant of Kaposi sarcoma (KS), which mimics benign pyogenic granuloma both clinically and histologically. We report a case of PGLKS of the toe occurring in a HIV-positive individual. It presented as a 2cm skin swelling of 2 weeks’ duration which was clinically felt to be a pyogenic granuloma. Histopathological examination revealed a polypoid atypical vascular lesion with overlying peripheral epidermal collarette. Spindle cell proliferation typically seen in KS was also identified, which was positive for human herpesvirus 8 (HHV8) by immunohistochemistry, confirming the diagnosis of PGLKS. Upon review of the literature, our case is the 29th case of PGLKS reported to date, and only the sixth in Asian population. Particular attention to histomorphology, and demonstration of HHV8 in lesional tissue will aid accurate diagnosis of this rare entity.

Highlights

Pyogenic granuloma-like Kaposi sarcoma (PGLKS) is a recent addition to histological variants of Kaposi sarcoma (KS)
We report a case of PGLKS in a human immunodeficiency virus (HIV)-positive patient seen in our institution and performed a literature search on SNOMED, PubMed Central and Google Scholar databases for other reported PGLKS cases far
CASE PRESENTATION A 28-year-old Malaysian man of Indian descent presented to the Dermatology Clinic with a two-week history of a swelling on his right 4th toe, which bled on trauma

Summary

INTRODUCTION

Pyogenic granuloma-like Kaposi sarcoma (PGLKS) is a recent addition to histological variants of Kaposi sarcoma (KS). CASE PRESENTATION A 28-year-old Malaysian man of Indian descent presented to the Dermatology Clinic with a two-week history of a swelling on his right 4th toe, which bled on trauma. He was HIV-positive with CD4 count of 27 cells/mm and was on highly active antiretroviral therapy (HAART) but had defaulted treatment. The dermis was replaced by a cellular lesion composed of proliferated vascular channels, predominantly thin walled vessels, with slit-like anastomosing pattern and an epidermal collarette (Figure 1). These were admixed with small arteriole-like vessels and occasional ectatic vessels. The morphological features and immunohistochemical profile were consistent with pyogenic granuloma-like Kaposi sarcoma (PGLKS)

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DISCUSSION

CONCLUSION

Conflicts of interest