AEGiS-15IAC: Value of dermopathology for differential diagnosis in AIDS-related Kaposi's sarcoma (KS).

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Value of dermopathology for differential diagnosis in AIDS-related Kaposi's sarcoma (KS).

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10293)

Gulotta HC, Troncoso AR, Rodriguez Rios E
Francisco Muniz Hospital, Buenos Aires, Argentina

BACKGROUND: KS represented the AIDS-defining diagnosis in the early years of the epidemic. It cannot be distinguished with certainly from other vessels tumors, without the use of biopsy. From January 1, 1990, to December 31, 2002, files of 159 adult HIV-infected patients (pts) derived for KS, based on clinical criteria, were studied retrospectively.

METHODS: Clinical history, clinical picture and pathological features of patients with of probable KS were reviewed. In all pts the biopsy indication was suspected KS. A specimen skin for biopsy was obtained and examined by light microscopy. All sections were stained with hematoxilin-eosin (H&E). Lesions were classified as related to or not-related to HIV/AIDS.

RESULTS: 159 patients were evaluated and definitive diagnosis was made in 132. Skin histology was not available in 27 pts. On these 132 pts with tentative diagnosis of KS, 68 had KS (51.51%). B cell lymphoma was found in 21 pts (15.90%), hemangiopericytoma in 4 pts (3.03%), pyogenic granuloma in 2 pts (1.51%) and dermatofibroma in 1 subjects (0.75%). Melano-epithelioma was observed in 6 cases (4.54%) and angiosarcoma in five (3.78%). We found 17 (12.87%) instances of bacillary angiomatosis in 132 cases of presumptive diagnosis of KS. In 1,51% of the patients a pathological findings was obtained without clear histological definition. Six biopsies (4.54%) were nondiagnostic. In 96,1% a clear-cut morphological diagnosis could be established. History of injury was presented in 33 % of cases.

CONCLUSIONS: The proportion of biopsies of lesions that were diagnostic and thereby contributed to the patients' therapeutic management was rather than 95%. Usually, the clinical picture of KS alone is distinctive and diagnostic. When the lesions are few in number, the clinical distinction from others vascular tumors may be difficult, correlation between the clinical and histopathological observations may be necessary for diagnosis.

Keywords: AEGIS, Sarcoma, Kaposi, Diagnosis, Differential, Acquired Immunodeficiency Syndrome, Hemangiosarcoma, Skin Neoplasms, HIV, HIV Infections, HIV Seropositivity, Granuloma, Pyogenic, Dermatofibroma, Hematologic Tests, HIV Seronegativity, Prognosis, HIV-1, Skin, Adult, Humans, diagnosis, Ethics, immunology

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B10293