Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma

Abstract

BackgroundIn this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized.MethodsA total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated.ResultsVesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed.ConclusionsOur findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474

Cavernous Hemangioma-Like Kaposi Sarcoma: Histomorphologic Features and Differential Diagnosis

“…There are a few studies studying histological subtypes of KS in large samples [2–6, 16, 17]. In this study 185 classical-type cutaneous KS lesions from 79 patients were retrospectively assessed, and two cases showing cavernous hemangioma-like features were reported with regard to histopathological features and differential diagnosis in company with the literature data.…”

An unusual presentation of toe blisters

“…1 This subset accounts for < 5% of all KS cases, has a predilection for the legs and a predisposition for male patients aged 50-70 years. 2 Vesicles and bullae are often described in association with the typical violaceous patches and plaques of KS. Conversely, our patient presented with bullae in the absence of typical KS lesions.…”

“…The clinical course is indolent and does not appear to be more aggressive than other KS subtypes. 2 LLKS is characterized histologically by lymphangioma-like foci of dilated and anastomosing channels lined by single-layered endothelial cells with minimal cytological atypia. 3 In our patient's biopsy, lymphangioma-like spaces coexisted with the typical spindle-cell proliferation of immature blood vessels dissecting the collagen bundles of KS.…”

“…Lymphangiectasia from tumoral obstruction and pronounced peritumoral oedema have been proposed as alternative mechanisms for vesiculobullous KS. 2 KS is increasingly being reported in MSM who are immunocompetent and seronegative for HIV. 5 These patients tend to be younger, have lesions on the legs, are less likely to have mucosal or visceral involvement, and respond well to treatment.…”

Skin Blister Formation and Subepidermal Bullous Disorders

“…Skin blistering diseases are clinically polymorphic large-group disorders and they sometimes may be devastating. These disorders may be classified according to [1] the level of the blister: subcorneal, mid epidermis, suprabasal, subepidermal; [2] the mechanism of blister formation (spongiosis, acantholysis, blistering degeneration, or epidermolysis); and [3] the type of inflammation (neutrophilic, lymphocytic, eosinophilic, mixed) [1]. In this section, pemphigoid group diseases such as bullous pemphigoid, mucous membrane pemphigoid, acquired epidermolysis bullosa, linear IgA bullous dermatosis, and anti p-200 pemphigoid will be explained with a brief introduction to blistering diseases of the skin.…”