PATHOLOGY OF KAPOSI'S SARCOMA

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

PATHOLOGY OF KAPOSI'S SARCOMA

Kaposi's Sarcoma: Pathophysiology and Clinical Management. Ziegler JL, Dorfman RF, eds. New York, Marcel Dekker, p. 23-70, 1988.. Unique Identifier : AIDSLINE ICDB/89650410
Templeton AC; Dept. of Pathology, Rush Medical Coll., Presbyterian-St. Luke's; Medical Center, Chicago, IL

Abstract: Classic histopathology of Kaposi's sarcoma (KS), its clinical subtypes, evolution of cutaneous KS, differential diagnosis, and distribution of lesions and their characteristics in different tissues are reviewed. Lesions of the skin, mouth and gastrointestinal tract, respiratory tract, lymph nodes, spleen, skeleton, liver, CNS, and unusual sites are described. The classic mixture of spindle cells and capillary vascular spaces is found in the vast majority of lesions of patients with KS, regardless of the clinical pattern exhibited. This means that diagnosis can be made confidently in most situations with paraffin sections stained with hematoxylin and eosin. Difficulties are encountered in the skin and lymph nodes, particularly at the interface of granulation tissue and in early lesions of KS. The key observations that strengthen the diagnosis are presence of spindle cells, erythrophagocytosis, and clusters of eosinophilic inclusions in KS and the presence of polymorphonuclear leukocytes in granulation tissue. In difficult cases, electron microscopy is distinctive in that microscopic vessels within the tumor nodule exhibit a lack of perithelial investment and an incomplete basement membrane. Underneath mucosal or cutaneous surfaces, the tumor displays plaque to nodule progression, with ulceration occurring late in the disease. In parenchymal organs (eg, lung, liver, and kidney) the tumor adopts a sheathlike investment of major vessels and ducts, with nodules occurring infrequently. The rarity of involvement of the brain is confirmed; this may relate to the lack of lymphatic channels at this site. (55 Refs)

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/PATHOLOGY Diagnosis, Differential Human Lymph Nodes/PATHOLOGY Lymphatic Metastasis Neoplasms, Multiple Primary/PATHOLOGY Sarcoma, Kaposi's/*PATHOLOGY Skin/PATHOLOGY Skin Neoplasms/*PATHOLOGY MONOGRAPH REVIEW, TUTORIAL REVIEW

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