Kaposi's sarcoma

Kaposi's sarcoma (KS) is a form of cancer that affects the cells lining blood vessels or lymphatic vessels, most frequently characterized by abnormal growths, or tumors, on the skin. It was first described by Hungarian dermatologist Moritz Kaposi in the late 19th century. This disease is particularly common in patients with immunosuppression, such as those with HIV/AIDS.

Kaposi's Sarcoma

Epidemiology

Kaposi's sarcoma is categorized into four distinct types: classic, endemic, iatrogenic, and epidemic (AIDS-related). The geographic distribution, prevalence, and patient demographics differ significantly for each type. Classic KS generally affects older individuals of Mediterranean, Middle Eastern, or Eastern European descent. Endemic KS is seen in Africa, while iatrogenic KS develops in individuals on immunosuppressive therapy, and epidemic KS is associated with HIV/AIDS worldwide.

Kaposis sarcoma 01

Pathophysiology

Kaposi's sarcoma is a complex, multicentric vascular neoplasm that results from infection by Kaposi's sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8). This virus manipulates the cell cycle of the infected cells, inducing uncontrolled growth and the formation of new blood vessels, contributing to the tumor's characteristic appearance.

Clinical Features

Kaposi's sarcoma typically presents as painless, purplish-blue or dark brown/black skin lesions that may appear anywhere on the body. Lesions can also develop in the mouth, lymph nodes, or internal organs. In severe cases, the disease can cause complications such as lymphedema or gastrointestinal bleeding.

Diagnosis

Diagnosis of Kaposi's sarcoma involves a combination of clinical examination and histopathological evaluation of a biopsy specimen. Other diagnostic methods may include imaging techniques like computed tomography (CT) or magnetic resonance imaging (MRI) to identify internal lesions. Presence of HHV-8 can be confirmed through serologic testing or molecular techniques such as polymerase chain reaction (PCR).

Treatment

The treatment of Kaposi's sarcoma varies depending on the severity and extent of the disease. Localized lesions may be treated with radiation therapy, intralesional chemotherapy, or surgical excision. Systemic treatment options include chemotherapy, immunotherapy, and antiretroviral therapy (ART) for HIV-associated KS.

Prognosis and Survival

The prognosis of Kaposi's sarcoma depends on multiple factors, including the type of KS, the patient's overall health, and access to treatment. AIDS-related Kaposi's sarcoma has a better prognosis in regions where ART is readily available.

See Also

• Cancer
• HIV/AIDS
• Kaposi's sarcoma-associated herpesvirus
• Immunosuppression
• Chemotherapy
• Radiation therapy
• Immunotherapy

References

• Antman K, Chang Y. (2000). Kaposi's sarcoma. New England Journal of Medicine, 342(14), 1027-1038.
• Ganem D. (2006). KSHV infection and the pathogenesis of Kaposi's sarcoma. Annual Review of Pathology: Mechanisms of Disease, 1, 273-296.
• Martin JN, et al. (1998). Sexual transmission and the natural history of human herpesvirus 8 infection. New England Journal of Medicine, 338(14), 948-954.

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