Endoscopic resection for the diagnosis of visceral Kaposi?s sarcoma

Sato, Junichi; Sogame, Yoshio; Kataoka, Keisuke; Kanemitsu, Daisuke; Takada, Ryusuke; Ito, Reiko; Motoyoshi, Tomoko; Mitsufuji, Shoji; Okanoue, Takeshi; Akioka, Kiyokazu; Okamoto, Masahiko; Yoshimura, Norio

doi:10.1007/s00535-004-1500-0

Cited by 8 publications

(9 citation statements)

References 25 publications

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“…Obtaining sufficient tissue samples is necessary for an accurate diagnosis. [6] Histology usually reveal proliferating spindle cells that are believed to be derived from lymphatic endothelium since they are frequently positive for lymphatic endothelial cell markers such as CD34, CD31, D2-40, and hyaluronan receptor LYVE-1. [7] FHI-1 test (monoclonal antibodies against the carboxyl terminal end of the FLI-1 protein) is usually positive and is helpful to differentiate Kaposi tumor from nonvascular tumors such as rhabdomyosarcomas, desmoplastic small round cell tumors, high-grade pleomorphic sarcomas, and colonic adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Kaposi′s sarcoma presenting as ileocolic intussusception

2013

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Context:Kaposi's sarcoma (KS) is the most common neoplasm in patients with acquired immune deficiency syndrome (AIDS). Gastrointestinal (GI) involvement with KS commonly occurs in association with cutaneous lesions or lymph node involvement, with GI tract involvement alone occurring in only 3.5% of cases. There are several case reports described in the literature about asymptomatic intestinal KS with skin manifestations. Although GI KS is usually asymptomatic, hemorrhages from the oral cavity, esophagus, stomach, and large bowel have been reported in this disease.Case Report:Our case is unique, in a way that the patient does not have skin manifestation, and also is that the first manifestation presented as acute intestinal intussusception and obstruction with nodular mass lesions of the stomach and GI tract due to GI KS.Conclusion:As a differential diagnosis of KS, nonHodgkin lymphomas frequently involve the gut in AIDS patients. Furthermore, tumors of the gut with spindle-shaped cells such as leiomyomas, rhabdomyosarcomas, high-grade pleomorphic sarcomas, or GI stromal tumors have to be considered in the differential diagnosis. Overall, the visceral involvement of the KS is usually associated with poor prognosis. Our case illustrates the importance of physicians to recognize GI KS as a differential diagnosis for HIV positive patients with recurrent abdominal pain. It is commonly occurs in association with cutaneous lesions or lymph node involvement and rarely presents with GI involvement alone, which is makes it a challenge to the physician.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal Kaposi′s sarcoma presenting as ileocolic intussusception

2013

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“…In our case the HIV infection was not known at the time of presentation and the patient’s GI symptoms were not associated with other symptoms that could lead to the suspicion of AIDS. In typical cases of gastric KS upper endoscopy reveals red–purple nodules,1 whose sampling does not need particular precautions 1 , 8. However, occasionally the endoscopic findings are more similar to common benign lesions, such as peptic ulcer 9.…”

Section: Discussionmentioning

confidence: 99%

Kaposi sarcoma of the stomach: a case report

Taccogna

Crescenzi²,

Stasi³

et al. 2009

Case Reports

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A 60-year-old man presented with persistent dysphagia and weight loss of 2-months duration. An upper GI endoscopy revealed mycotic oesophagitis and chronic gastritis with two ulcers of the gastric body and antrum. Repeat endoscopy was performed after medical treatment failed, and histological examination on new biopsy samples led to a diagnosis of Kaposi sarcoma of the stomach. HIV infection was not known at this time; however, the patient was tested after the diagnosis of Kaposi sarcoma was made and found to be HIV positive. An adequate biopsy sampling was required for histological diagnosis and the use of immunohistochemical markers, especially human herpesvirus 8 (HHV8) antibodies, supplied valid diagnostic support. This case underlines the importance of an accurate evaluation of vascular proliferation in gastrointestinal biopsies even in patients without clinical evidence of HIV-related pathology.

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“…Site of GI involvement was classified into 7 regions: esophagus, stomach, duodenum, ileum, right-side colon (cecum, ascending colon, and transverse colon), left-side colon (descending colon and sigmoid colon), and rectum. Macroscopic findings were evaluated in the presence of reddish mucosa with patches (Figure 2(a)), polypoid lesion (Figure 2(b)), submucosal tumor (SMT), SMT with ulceration (Figure 2(c)), and bulky mass (Figure 2(d)), as previously reported [13, 17, 19–23]. Ulceration was defined endoscopically as a distinct, visible crater >5 mm in diameter with a slough base.…”

Section: Methodsmentioning

confidence: 97%

“…Histopathologically, GI-KS is characterized by spindle cells that form vascular channels, which fill with blood cells [17, 18]. Endoscopically, GI-KS has various macroscopic presentations: patches, polypoid lesions, submucosal nodules, bulky masses, and ulcerations [13, 17, 19–23]. For submucosal nodules especially, endoscopic biopsy sampling has been known to yield false-negative results (FNRs) [17, 23–25].…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopically, GI-KS has various macroscopic presentations: patches, polypoid lesions, submucosal nodules, bulky masses, and ulcerations [13, 17, 19–23]. For submucosal nodules especially, endoscopic biopsy sampling has been known to yield false-negative results (FNRs) [17, 23–25]. Some GI-KS lesions might be more difficult to identify histologically depending on their location, size, or macroscopic appearance; however, which findings are related with false-negative histological results remain unknown.…”

Section: Introductionmentioning

confidence: 99%

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False-Negative Results of Endoscopic Biopsy in the Diagnosis of Gastrointestinal Kaposi’s Sarcoma in HIV-Infected Patients

Nagata

Sekine

Igari

et al. 2012

Pathology Research International

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Kaposi's sarcoma (KS) is a rare endothelial neoplasm mainly involving the skin, but it is often associated with AIDS. Diagnosis of gastrointestinal (GI) tract KS, a common site of visceral involvement in AIDS, is important, but endoscopic biopsy carries a risk of false-negative results (FNRs) due to its submucosal appearance. This study sought to determine the rate and causes of FNR for endoscopic biopsy of GI-KS lesions. Endoscopic biopsy samples of 116 GI-KS lesions were reviewed retrospectively. All GI-KS lesions were confirmed to be resolved following KS therapy. FNRs were yielded for 41 of the lesions (35.3%). Among upper and lower GI sites, the esophagus was the only site significantly associated with FNRs (P < 0.01). Small size (<10 mm) and patches found on endoscopy were significantly associated with FNRs (P < 0.05). Findings of submucosal tumor (SMT) with ulceration were significantly associated with true-positive results (P < 0.05). In conclusion, FNRs were found in 35.3% of GI-KS lesions and were especially related to the site of the esophagus and endoscopic early stage (small size or patch appearance). An SMT with ulceration may be relatively easy to diagnose on endoscopic biopsy. Caution should be exercised when performing endoscopic biopsy of these lesions in AIDS patients and evaluating the histological features.

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Endoscopic resection for the diagnosis of visceral Kaposi?s sarcoma

Cited by 8 publications

References 25 publications

Gastrointestinal Kaposi′s sarcoma presenting as ileocolic intussusception

Gastrointestinal Kaposi′s sarcoma presenting as ileocolic intussusception

Kaposi sarcoma of the stomach: a case report

False-Negative Results of Endoscopic Biopsy in the Diagnosis of Gastrointestinal Kaposi’s Sarcoma in HIV-Infected Patients

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