Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
ATLAS OF THE GROSS AND MICROSCOPIC FEATURES OF KAPOSI'S SARCOMA
Kaposi's Sarcoma: A Text and Atlas. Gottlieb GJ, Ackerman AB, eds. Philadelphia, Lea and Febiger, p. 29-71, 1988.. Unique Identifier : AIDSLINE ICDB/88647195 Ackerman AB; Gottlieb GJ; New York Univ. Sch. of Medicine, New York, NY
Abstract:
The appearance of Kaposi's sarcoma (KS) at the gross and microscopic level is described and illustrated, including four color plates showing the gross appearance of skin lesions. Lesions of KS present first as pinpoint macules. In time, such macules may enlarge horizontally and become patches or may enlarge vertically to form papules or plaques, and still later to form nodules and tumors that may eventually ulcerate. The color of the lesions may vary markedly depending upon their stages of evolution, the background color of surrounding unaffected skin, and the anatomic site that bears them. Lesions of KS assume various shapes. Macules, papules, and plaques may be round, oval, oblong, linear, or irregular; they are usually, but not always, sharply circumscribed. Cutaneous lesions of KS may number from a solitary lesion to hundreds. The clinical diagnosis of lesions of KS in the skin is based primarily on morphologic characteristics (color, surface characteristics, and shape) and secondarily on configuration and distribution. The earliest histologic changes of KS in the skin are detectable in macules and patches. Such changes are most often seen in the upper half of the reticular dermis and surround preexisting vascular plexuses. In a second pattern (pseudogranulomatous), early flat lesions of KS are characterized by aggregations of cells that ordinarily are uniform and surround preexisting vascular plexuses. Papules or plaques of KS show changes that are merely exaggerations of those of macules and patches. In time, some lesions of KS become nodules or tumors. At this stage, spindle cells predominate and form interweaving fascicles with erythrocytes in interstices between the spindle cells. Nodules differ from early macules and papules, often by showing cytologic atypia and pleomorphism of spindle cells. The neoplastic cells of lesions of KS may contain erythrocytes within their cytoplasm (erythrophagocytosis) and so-called 'hyaline' bodies. Based on histologic studies of the skin and other organs of patients with KS, the authors conclude that KS is not a sarcoma. The changes in every organ affected proceed through a predictable and repeatable sequence analogous to the patterns seen in the skin. This indicates that the proliferation of cells is multifocal. Furthermore, neoplastic cells are never seen within the lumina of vascular spaces. KS has no capability for metastasis and, therefore, is not a true sarcoma.
Keywords: Acquired Immunodeficiency Syndrome/*PATHOLOGY Cell Transformation, Neoplastic/PATHOLOGY Cytoplasm/ULTRASTRUCTURE Human Neoplasms, Multiple Primary/PATHOLOGY Sarcoma, Kaposi's/*PATHOLOGY Skin/PATHOLOGY Skin Neoplasms/*PATHOLOGY MONOGRAPH
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Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
