Appearance Of Kaposi's Sarcoma Research Articles

1932 The Answer Is on Your Skin: A Case of GI Bleeding Secondary to Kaposi Sarcoma

INTRODUCTION: GI tract bleeding in AIDS patients carries with it a significant degree of morbidity, with a unique differential including different opportunistic infections and malignancies. Kaposi Sarcoma (KS) is a form of malignancy associated with the human herpes-virus 8, recognized as an AIDS defining illness, and is typically recognized by violaceous cutaneous lesions. KS can also have widespread involvement of the visceral organs including the GI tract, where it can manifest as anything from GI bleeding to diarrhea, abdominal pain, nausea/vomiting and weight loss. Here, we describe a case of AIDS-related KS leading to profound GI bleeding. CASE DESCRIPTION/METHODS: A 29 year old male with a history of AIDS (CD4 of 44 cells/mm3and viral load of 18,000 copies/mL) in the setting of anti-retroviral therapy (ART) non-compliance presented with subacute onset shortness of breath, palpitations and malaise over the prior week. Upon review of systems, he endorsed diarrhea and melena over the same timeframe, while denying any other GI tract symptoms. Vital signs on presentation were significant for tachycardia to 103 bpm. Physical exam was notable for violaceous small lesions in buccal mucosa, hard palate, arms and back. His initial labs indicated severe anemia with a hemoglobin level of 4.9 g/dL with a ferritin level of less than 10 indicating severe iron deficiency anemia. After initial resuscitation, the patient underwent upper and lower endoscopy. His EGD showed multiple small round, heaped up ulcers in the gastric antrum, body, and fundus, along with similar ulcers in the second part of the duodenum. His colonoscopy showed similar lesions found in the transverse colon and rectum as illustrated in the images below. Biopsies taken from those lesions along with skin punch biopsies confirmed the diagnosis of Kaposi Sarcoma. He was discharged on Emtricitabine/Tenofovir and Darunavir/Cobicistat with follow up after several months showing dramatic improvement in his skin lesions and resolution of his gastrointestinal symptoms. DISCUSSION: The endoscopic appearance of KS in the GI tract is unique, often appearing as hemorrhagic nodules or plaques, however still requires tissue biopsy for diagnosis. Treatment is centered on ART with the use of systemic chemotherapy typically only needed in case of severe symptoms or lack of response to ART. Our case is a testament to the broad differential to be considered in HIV/AIDS patients with GI bleeding, of which Kaposi Sarcoma should be considered.

First Diagnosed Case of Steroid-induced Kaposi's Sarcoma in Mongolia

Objectives: Kaposi's sarcoma (KS) is a vascular neoplasm with four main types. We report the first diagnosed case of steroid-induced KS in a non-HIV patient in Mongolia. Methods: A 57-year-old man presented hemorrhagic spots on his body after seven months of corticosteroid therapy due to the glomerulonephritis. Upon examination, the morphology, histopathology and immunohistochemistry indicated human herpes virus-8 (HHV-8) positive KS. Results: After the dose reduction of corticosteroids the lesions remarkably diminished in size and almost resolved as observed at the six-month follow-up. Conclusion: Medical professionals should be aware of the appearance of KS in patients receiving immunosuppressive therapies.

What is your diagnosis? A solitary purple papule on the arm-Answer.

Below is the answer to the quiz by Dr. Senel et al presented in the previous issue of Dermatology Practical & Conceptual [2014;4(4):13]. Diagnosis: Kaposi sarcoma. Kaposi sarcoma (KS) was first described by Kaposi in 1872. There are four clinical types of the disease: classic, endemic, epidemic and iatrogenic [1]. Iatrogenic KS develops in patients taking immunosuppressive treatment. Bluish-reddish coloration is seen in 84% of KS lesions in dermatoscopy. Rainbow pattern and scaly surface are other dermatoscopic features of KS (36% and 15%, respectively) [2]. Multicolored rainbow pattern is the most diagnostic appearance of KS in dermatoscopic evaluation and is associated with vascular lumen-rich histological sub-type [3]. This pattern can be rarely seen in the dermatoscopy of melanoma [4]. Congratulations to Dr. Arina Vashkevich (ur.liam@khsavaa), who was the first to send us the correct answer!

Kaposi's Sarcoma Presenting with Endobronchial Lesions

Kaposi's Sarcoma Presenting with Endobronchial Lesions

Human herpesvirus-8 and Kaposi's sarcoma: Relationship with the multistep concept of tumorigenesis

Kaposi's sarcoma (KS) develops through discrete inflammatory-angiogenic stages of polyclonal nature (early-stage lesions) to monomorphic nodules of spindle-shaped cells that can be clonal (late-stage lesions) and resemble true sarcomas. Molecular and epidemiological studies indicate that development of KS is tightly associated with infection by the human herpesvirus-8 (HHV-8). However, only individuals with specific conditions of immunodysregulation develop KS. In these individuals the systemic and tissue increase of Th-1-type cytokines (IC) reactivate HHV-8 infection, leading to increased viral load, antibody titers, and an expanded cell tropism that precedes the clinical appearance of KS. Recruitment of the virus into tissues by infected monocytes and other cell types is facilitated by the endothelial cell activation due to IC. In clinical lesions, HHV-8 infection increases with lesion stage and in late-stage lesions most of the spindle cells are latently infected, whereas only few lyrically infected cells are present, suggesting that latent genes may have a role in the transformation of the early inflammatory-hyperplastic lesion into a real sarcoma. The development of tumors, however, is regulated through a multistep process based on the acquisition by cells of several different capabilities leading to malignant growth. Here we review the available data on the expression of HHV-8-encoded genes in primary KS lesions and, in view of their biological activity, analyze their potential function in different steps of tumorigenesis. By this pragmatic approach interesting insights into potential key functions of HHV-8-encoded genes are found and steps of potential cooperativity with other viral factors (HIV-1-Tat) in the pathogenesis of KS are identified.

Detection of human herpesvirus 8 DNA sequences before the appearance of Kaposi's sarcoma in human immunodeficiency virus (HIV)-positive subjects with a known date of HIV seroconversion.

The presence of human herpesvirus 8 (HHV-8) DNA sequences was sought by polymerase chain reaction (PCR) in peripheral blood mononuclear cells of 4 groups: 6 human immunodeficiency virus (HIV)-infected persons with well-defined dates of seroconversion, during the period between the diagnosis of HIV infection and the appearance of Kaposi's sarcoma (KS); 45 HIV-positive persons with no symptoms of HIV infection; 11 AIDS patients with KS; and 14 AIDS patients without KS. HHV-8 DNA PCR was positive in 3 of the 6 patients during HIV infection preceding the appearance of KS and in all but 1 of 11 AIDS patients with KS. HHV-8 DNA PCR was negative in all but 1 of the 45 HIV-positive persons with no symptoms of infection and in all but 1 AIDS patient without KS. These results indicate that HHV-8 DNA may be detected several years before the occurrence of KS in HIV-infected subjects.

Influence of HIV Epidemic on the Incidence of Kaposi??s Sarcoma in Zambian Children

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (KS) is well documented in adults. However, very little information is available about KS in the pediatric age group. A retrospectively study was undertaken at the University Teaching Hospital (UTH), Lusaka, Zambia, to define the incidence and clinical profile of KS in Zambian children over the last 13 years and to determine the influence, if any, of the current human immunodeficiency virus (HIV) epidemic on the pattern of pediatric KS. All the histopathological records from 1980 to 1992 were reviewed and all cases of KS along with the total number of malignancies, both in children and adults, were analyzed. Along with this, 17 of 23 case files of pediatric KS patients treated at the UTH since 1984 were retrieved and clinical details recorded. Of a total of 915 cases of KS, 85 (9.25%) were in children < 14 years of age. The age ranged from 7 months to 14 years, with an average of 5.62 years; the male/female ratio was 1.76:1. A significant increase in the incidence of pediatric KS has been recorded since 1987 (p < 0.001). This coincides with the advent of the HIV epidemic in the country. The disease was aggressive and fulminant in pediatric patients. More than 80% HIV seropositivity was detected. Children with blood transfusion-related HIV infection had cutaneous or lymphocutaneous disease, indicating that the mode of acquisition of HIV infection may influence the clinical appearance of KS. Thus, HIV-associated KS in children is becoming a common entity in Zambia. An urgent prospective epidemiologic study is needed to address this problem in HIV-affected regions.

The appearance of kaposi sarcoma during corticosteroid therapy

Four epidemiologic types of Kaposi sarcoma (KS) are known: classic KS, endemic African KS, epidemic or acquired immunodeficiency syndrome-related KS, and KS associated with immunosuppressive therapy. In most of the latter patients, KS was reported to have developed after organ transplantation, particularly renal transplantation. Thirty-nine patients who have not had a transplant have been reported to have KS associated with corticosteroid therapy. The authors studied 10 patients with the appearance of KS during corticosteroid therapy (6 men, 4 women; age range, 42-79 years) who were treated with corticosteroids for autoimmune disorders (5 patients), lymphoproliferative disorders (2 patients), and diseases unrelated to the immune system (3 patients). Genetically programmed susceptibility to corticosteroid-related KS was suggested by the descent of the study patients as well as most of those reported previously. The prognosis was guarded in all the study patients. Corticosteroids should be withdrawn to achieve clinical remission.

Epidemic Kaposi’s sarcoma in Italy, a country with intravenous drug users as the main group affected by HIV infection

The Italian Cooperative Group on AIDS & Tumors (GICAT) is collecting data on the epidemiological and clinical features of Kaposi's sarcoma (KS) in Italy, a country where intravenous drug users (IVDUs) comprise the largest group affected by AIDS. As of December 31st 1989, among 5317 cases of CDC-defined AIDS reported to the National Registry of AIDS, there were 419 (8%) cases of KS. Twenty-five percent of all of the homosexual men with CDC-defined AIDS had KS, while only 3% of the IVDU patients with CDC-defined AIDS had KS. The first case of KS was observed in 1982, 2 cases in 1983, 7 cases in 1984, 17 cases in 1985, 55 cases in 1986, 89 cases in 1987, 120 cases in 1988 and 128 cases in 1989. Of the 226 cases of KS reported to GICAT, 60% were in homosexual men, 21% in IVDUs, and 9% in heterosexuals. An increased number of KS has been observed since 1982, although the number of new cases in the past year seems to have been stable, possibly due to the usual delay in notification. There is, however, an actual decrease of the percentage of KS among AIDS patients, from 18% in 1984 to 6% in 1989. Almost half of the patients had had a diagnosis of AIDS prior to the appearance of KS, but in 25% of the patients KS was the first AIDS manifestation. Almost all patients had skin involvement either alone or in association with other sites, whereas very few patients had only lymph node involvement. Only treatment with alpha-2 interferon was able to obtain complete remission in 9% of evaluable patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Dermatophytosis Mimicking Kaposi’s Sarcoma in Human Immunodeficiency Virus Disease

Kaposi's sarcoma (KS) is an important finding in patients infected with human immunodeficiency virus (HIV), with a distinctive spectrum of clinical presentations. Three cases of dermatophytosis in HIV-infected patients are presented which clinically mimic the appearance of KS. This new observation underscores the importance of histopathologic examination in the evaluation of skin lesions suspicious for the diagnosis of KS. The other clinical mimickers of KS are reviewed.

Kaposi's sarcoma following allergic angiitis.

Case Reports1 April 1955KAPOSI'S SARCOMA FOLLOWING ALLERGIC ANGIITISJOSEPH T. MCGINN, M.D., JOSEPH J. RICCA, M. D., JOHN F. CURRIN, M.D.JOSEPH T. MCGINN, M.D.Search for more papers by this author, JOSEPH J. RICCA, M. D.Search for more papers by this author, JOHN F. CURRIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-42-4-921 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONKaposi's sarcoma is an uncommon neoplastic lesion, usually of low grade malignancy, which is thought to be of vascular tissue origin. Most authors, including Algerter and Peale,1 classify it as an angiosarcoma. The disease seems to have a predilection for Central European stock, affecting northern Italians most frequently, then Jews, Russians and Poles, in that order. The most common age of onset is in the fifth and sixth decades; males are the more frequent victims by a ratio of 20:1.Kaposi's sarcoma has been reported frequently in association with malignancies of the lymphatic system, such as mycosis fungoides,2, 3...Bibliography1. AlgerterPeale EEAR: Kaposi's sarcoma: a critical survey, Arch. Path. 34: 413-422, 1942. Google Scholar2. LaneGreenwood CGAM: Lymphoblastoma (mycosis fungoides) and hemorrhagic sarcoma of Kaposi in the same person, Arch. Dermat. and Syph. 27: 643 (Apr.) 1933. CrossrefGoogle Scholar3. Lapowski P: Idiopathic multiple pigment sarcoma (Kaposi), Arch. Dermat. and Syph. 33: 170 (Jan.) 1936. Google Scholar4. BluefarbWebster SNJR: Kaposi's sarcoma associated with lymphosarcoma, Arch. Int. Med. 91: 97-105, 1953. CrossrefGoogle Scholar5. Talbott JH: Clinical manifestations of Hodgkin's disease, New York State J. Med. 47: 1883, 1947. MedlineGoogle Scholar6. GreensteinConston RHAS: Co-existent Hodgkin's disease and Kaposi's sarcoma: report of a case with unusual clinical features, Am. J. M. Sc. 218: 384 (Oct). 1949. CrossrefMedlineGoogle Scholar7. Wolf J, in discussion on Rosen, I.: Kaposi's sarcoma associated with lymphatic leukemia, Arch. Dermat. and Syph. 48: 566 (Nov.) 1943. Google Scholar8. ColeCrump HNES: Report of two cases of idiopathic hemorrhagic sarcoma (Kaposi), the first complicated with lymphatic leukemia, Arch. Dermat. and Syph. 1: 283 (Mar.) 1920. CrossrefGoogle Scholar9. SachsGray WM: Kaposi's sarcoma and lymphatic leukemia: report of a case, Arch. Dermat. and Syph. 51: 325 (May) 1945. CrossrefGoogle Scholar10. GreppiBettoni EI: Splenomegalia emolitica ed angio-endothelioma cutaneo tipo Kaposi con associazione di agranulocitosi e sepsi orale: sindrome complesse di reticuloendoteliosi iper plastico-neoplastica, Arch. 1st. Biochim. ital. 4: 403 (Nov.) 1932. Google Scholar11. BeckerThatcher MSBS: Multiple idiopathic sarcoma of Kaposi, J. Invest. Dermat. 1: 379-395, 1938. CrossrefGoogle Scholar12. Dorffel J: Histogenesis of multiple idiopathic hemorrhagic sarcoma, Arch. Dermat. and Syph. 26: 608, 1932. CrossrefGoogle Scholar13. Dorffel J: Ueber einen Fall von Endotheliosis in Kindesalter, Dermat. Wchnschr. 89: 1178, 1929. Google Scholar14. OrmsbyMontgomery OSH: Diseases of the skin, 1945, Lea and Febiger, Philadelphia. Google Scholar15. MacKeeApollara GMAC: Multiple idiopathic hemorrhagic sarcoma (Kaposi), Am. J. Cancer 26: 1-28, 1936. CrossrefGoogle Scholar16. AllenBarkerHines EVME: Peripheral vascular disease, 1946, W. B. Saunders Co., Philadelphia. Google Scholar17. Zeek PM: Periarteritis nodosa and other forms of necrotizing angiitis, New England J. Med. 248: 764-772, 1953. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Brooklyn, N. Y.*Received for publication May 3, 1954.From the Department of Medicine, Long Island College Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFamilial Classic Kaposi Sarcoma in Two Siblings: Case Report and Literature ReviewKaposi's sarcoma in rheumatic diseasesSkin Lesions in Melanoma and Kaposi’s SarcomaClassic Kaposi sarcomaKaposi's sarcoma with visceral involvement after intraarticular and epidural injections of corticosteroidsThe appearance of kaposi sarcoma during corticosteroid therapyKaposi's sarcoma in rheumatoid arthritisMendelian Predisposition to LymphomagenesisFamilial Occurrence of Kaposi's Sarcoma. Report of Two BrothersKaposi's sarcomaFamilial Kaposi's sarcomaKaposi's sarcoma and immunosuppressive therapy: an appraisalRetikulosenErbliche Aplasien, Hyperplasien und Tumoren (mit Ausnahme von Gefäßtumoren) 1 April 1955Volume 42, Issue 4Page: 921-927KeywordsHospital medicineJewish peopleKaposi sarcomaLesionsLymphatic systemVasculitis ePublished: 1 December 2008 Issue Published: 1 April 1955 PDF downloadLoading ...