Article

Kaposi's sarcoma of the gastrointestinal tract: report of two cases and review of the literature.

Department of Pathology, University of Bonn Medical School, Sigmund Freud Street 25, 53127 Bonn, Germany.
Pathology - Research and Practice (Impact Factor: 1.56). 02/2007; 203(4):227-31. DOI: 10.1016/j.prp.2007.01.007
Source: PubMed

ABSTRACT Involvement of Kaposi's sarcoma in the gastrointestinal tract is common in AIDS patients and can also occur in non-AIDS patients. However, the disease is usually asymptomatic and, due to tumor growth primarily in the submucosa, biopsy diagnosis is possible in less than 25%. In the present study, we describe two cases of Kaposi's sarcoma that were first diagnosed in the gastrointestinal tract of a 74-year-old patient who presented to the clinic with nausea and vomiting. On esophagogastroduodenoscopy, a lesion 0.7 cm in size was found. Histology revealed a Kaposi's sarcoma of the stomach with existing HHV8 infection, and there were negative tests for HIV. The second case is a 39-year-old patient with multiple lesions in the stomach and in the small and large intestine. The histology verified multiple Kaposi's sarcomas that were HHV 8-positive. Afterwards, the diagnosis of an HIV infection was made. Primary diagnosis of Kaposi's sarcoma of the gastrointestinal tract in HIV-negative patients is certainly rare and more frequently made in HIV patients. Nevertheless, Kaposi's sarcoma must always be considered in lesions of the gastrointestinal tract or in gastrointestinal bleeding and should lead to further elucidation of the causes.

0 Bookmarks
 · 
101 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Gastrointestinal Kaposi sarcoma (KS) is classical, but rare. The AKT signaling pathway plays a central role in G protein-coupled receptor, key protein of KS histogenesis, encoded by KSHV/HHV8. There is increasing evidence that rapamycin, acting on AKT pathway, may be useful in the treatment of KS, including in HIV patients. We aimed to study the expression pattern of AKT pathway proteins in gastrointestinal KS. Expression of AKT, 4EBP1, PTEN, mTOR was assessed in 19 gastrointestinal KS biopsies by immunohistochemistry (17 patients). Protein expression in tumor spindle cells and in intratumor stromal vascular endothelial cells was analyzed with regard to clinicomorphological features. Tumor AKT related to lack of marked extravasated erythrocytes, tumor PTEN to presence of intratumor hemosiderin (p = 0.04 for both comparisons). Presence of both extravasated erythrocytes and hemosiderin related directly to endothelial stromal vascular nuclear PTEN and to low endothelial mTOR (p = 0.4 and 0.03, respectively). High tumor 4EBP1 related to a high slit-type abnormal vascular component (p = 0.04). The results of our study suggest pro-permeability or pro-angiogenic roles for 4EBP1 and PTEN and, opposite roles for AKT and mTOR in KS. Our hypotheses warrant further studies to obtain more generally applicable results.
    Apmis 11/2013; · 1.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Kaposi sarcoma (KS) is known to be one of the three AIDS-defining neoplasms together with non-Hodgkin lymphoma and cervical carcinoma. Since the beginning of AIDS epidemics, KS has been frequently diagnosed as a skin or mucous tumour accompanied by a low CD4 count due to advanced HIV infection. In our report, we describe the case of KS diagnosed in an ART-naïve patient with a high CD4 cell count, who presents tissue changes on the hard palate and in the gastrointestinal tract, and finally skin changes. Diagnostic problems due to unreliable biopsy results and an aggressive form of KS involving several organs both complicated the procedures and delayed treatment. In conclusion, KS should be taken into consideration in differential diagnosis even in patients with a high CD4 count.
    HIV & AIDS Review. 01/2014;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite our decades of experience with Kaposi Sarcoma its true nature remains elusive. This angioproliferative disease of the vascular endothelium has a propensity to involve visceral organs in the immunocompromised population. There are four variants of the disease and each has its own pathogenesis and evolution. While the common sources of upper gastrointestinal bleeding are familiar to surgeons and critical care physicians, here we present the exceedingly rare report of upper gastrointestinal bleeding attributable to this malady, explore its successful management, and review the various forms of Kaposi Sarcoma including the strategies in regard to their management.
    Journal of gastrointestinal and liver diseases: JGLD 12/2013; 22(4):441-5. · 1.85 Impact Factor