A comparative study of Kaposi's sarcoma and granuloma pyogenicum in Uganda

Abstract

A comparison has been made between two vasoformative lesions, Kaposi's sarcoma and granuloma pyogenicum, as they are encountered in Uganda. Both are predominantly skin lesions arising in the distal extremities, may resemble each other clinically, and are widespread in their distribution in Ugandan communities. They bear a reciprocal relationship to each other as regards age and sex incidence, Kaposi's sarcoma being mainly a disease of adult males and granuloma pyogenicum a disease of immature males and females. Histologically there are many similarities between them, the essential difference being the presence of a spindle-cell sarcomatous element in Kaposi's sarcoma. The clinical behaviour reflects this difference in that granuloma pyogenicum develops quickly and appears to be self-limiting, while Kaposi's sarcoma is slowly progressive and shows much less tendency to regress.On the basis of these findings it is concluded that, although these two lesions may be completely unrelated, it is possible that both represent a response of the vasoformative elements in the skin to a similar form of initiating stimulus and that hormonal or sex-linked genetic factors determine which lesion will develop in response to this stimulus.The presence of intracytoplasmic inclusion in the tumour cells of Kaposi's sarcoma might be of significance in the histogenesis of this tumour, and of value in its histological differentiation from granuloma pyogenicum.

Kaposi's sarcoma in lymph nodes: histological study of lesions from 16 cases in Malawi.

“…Iron deposition within the tumour varied from none at all in some areas to moderately heavy deposition in others. Reticulin stains confirmed the observations of others (Lothe, 1963;Lee, 1968) that a delicate reticulin framework surrounded almost every cell. The amount of collagen demonstrated by Mallory's trichrome was extremely variable but some was present in almost all areas of tumour, often surrounding single cells and sometimes lining portions of vascular channels.…”

Case report 602

“…5) and a smaller proportion of spindle cells which formed slit-like vascular spaces and contained extravasated red blood cells (Fig. Hyaline globules, as have been reported in Kaposi's sarcoma, were not seen, and necrosis and cytologic atypia also was absent [1,2]. The spindle cells were bland and mitotic figures were infrequent.…”

The Histology of Borderline Cancer

“…Lesions of the same kind occur in tropical countries and give rise to much differential diagnostic difficulty. A comparative study of granuloma pyogenicum and Kaposi's sarcoma has been made by Lee (1968) who believes that both lesions may develop in response to the same stimulus, nature as yet unknown: in granuloma pyogenicum the blood vascular endothelial cell is primarily in-volved, in Kaposi's sarcoma a cell at some earlier stage of differentiation.…”