1/12. A unique case of a benign disseminated angioproliferation combining features of Kaposi's sarcoma and diffuse dermal angioendotheliomatosis.A female patient undergoing chronic hemodialysis had disseminated, violaceous, and partly ulcerated plaques develop on the trunk. Lesions had erupted simultaneously over a period of 4 weeks and resolved within 5 months after steroid treatment. By histopathology, the papillary dermis was densely filled with blood vessels lined by a single layer of differentiated endothelial cells, a growth pattern resembling diffuse dermal angioendotheliomatosis. In some areas, endothelial cells were spindle shaped and formed discontinuous lumina. Red blood cells were interspersed within these slits, giving the lesions a kaposiform appearance. By immunohistochemistry, endothelial cells reacted with the antibodies anti-von willebrand factor, anti-CD31, and anti-CD34 and with the lectin ulex europaeus-1. The course of the disease combined with the unusual histopathology makes this case a unique form of a benign disseminated kaposiform angioproliferation.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
2/12. factor xiiia expression in pseudo-Kaposi sarcoma.A 39-year-old man had pseudo-Kaposi sarcoma on his left foot. A biopsy specimen obtained from a cutaneous lesion showed increased numbers of vascular spaces, proliferation of fibroblast-like spindle cells, and deposition of hemosiderin in the dermis. Immunohistochemically, proliferative fibroblast-like spindle cells around the vessels were positive for anti-factor xiiia antibody. Excessive heat radiation was detected from the skin lesions by thermography.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
3/12. Primary palmoplantar Kaposi's sarcoma: an unusual presentation.A 65-year-old diabetic Saudi Arabian man taking glibenclamide for 9 years presented with painful reddish patches and plaques involving the palms and soles of 6 months' duration. These lesions started as small faint purple-red macules and gradually increased in number and size. The patient did not seek any medical advice other than for these painful lesions. His medical history was insignificant. On examination, the patient had multiple, discrete, dull red-to-violaceous and tender patches and plaques of variable sizes on both palms and soles (Figure 1 and Figure 2). His mucous membranes, scalp, and nails were normal. A systemic clinical examination was unremarkable other than an amputation of the distal phalanx of the left index. Result of routine laboratory investigations including complete blood cell count, liver and renal function tests, and chest x-ray were normal. An hiv test was negative. A punch skin biopsy taken from the left palm showed acanthosis and spongiosis in the epidermis. The dermis showed a large number of dilated, medium-sized capillaries with scanty extravasated red blood cells, marked infiltration of lymphocytes and histiocytes, and a few plasma cells (Figure 3 and Figure 4). immunohistochemistry results were positive for CD34 and CD68. polymerase chain reaction for human herpesvirus 8 was also positive. The treatment options, including cryotherapy and intralesional chemotherapy, were discussed with the patient but, unfortunately, he did not return for follow-up.- - - - - - - - - - ranking = 2keywords = dermis (Clic here for more details about this article) |
4/12. Kaposi's sarcoma and HTLV-III infection. Virus-like particles in skin lesions: experimental observations.skin biopsies from a subject affected by KS and AIDS were examined by means of EM. Samples were obtained both in correspondence of a typical nodule, and from an apparently normal area. The disease process had started at least 8 mo. before, and the patient showed a reduced number of OKT4 cells, with an inversion of the normal T4/T8 ratio. Besides that, high titre antibodies versus HTLV-III were present, whereas antibodies versus CMV and EBV were not demonstrable. light and electron microscopy demonstrated the typical picture of KS, with marked proliferation of undifferentiated endothelial and spindle-like cells within a network of collagen fibers. Neoformed capillaries very rarely showed an organization comparable to small vessel of normal dermis. Retro-virus-like particles recalling the ones described in lymph-nodes of subjects affected by AIDS by Armstrong et al. (1984) were observed in the skin tissue obtained in correspondence of the Kaposi lesion; the same were either isolated or gathered in small groups within cytoplasmic vescicles. Similar particles were not evidenced in the tissue obtained from normal skin. The interpretation of morphological aspects requests of course a great caution. However the observation seems to be noteworthy, specially if one considers the demonstrated association between retro-virus of HTLV-III group and AIDS, and that its unusual frequency as well as the malignancy in an immunodepressed host are as yet poorly understood.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
5/12. Kaposi's sarcoma. Origin and significance of lymphaticovenous connections.review of histopathological material in nine autopsies and 35 skin biopsy specimens of Kaposi's sarcoma in male homosexuals suggested that aberrant lymphaticovenous connections occur in the earliest stage of the Kaposi lesion. Venular glomeruloid structures in the dermis and their analogous radial venolymphatic channels in medium-sized and larger veins signified coupling of the lymphatic and venous systems, a characteristic previously noted in angiographic studies and considered to be unique in Kaposi's sarcoma. Lymphatic channels penetrated veins selectively rather than arteries, particularly in deep fat, liver, gastrointestinal submucosa and the hilum of lymph nodes. The initiation of the Kaposi lesion thus may be an abnormal recapitulation of the coupling of venous and lymphatic systems which occurs during embryonic growth. A chronological staging scheme is used which proposes lymphaticovenous union as the initial morphological differentiating event. The precise origin of the characteristic spindle cells in the developing lesion remains unclear, although convergent differentiation of lymphatic and blood vascular endothelium may be considered. Alteration of the microcirculation, particularly that distal to the capillary bed, may explain several of the histopathological and haemodynamic features of Kaposi's sarcoma, including lesional thrombosis and infarction, tissue haemorrhage, vascular dilatation, cavernous pseudoangiomas and acute right-sided heart failure.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
6/12. The histomorphology of Kaposi sarcoma in three homosexual men.Three homosexual men with acquired immunodeficiency syndrome (AIDS) were referred to Hvidovre Hospital, Copenhagen, during 1981. Biopsies from lymph nodes (case 2), skin (case 1 and 3), oral mucosal membrane (case 1) and lung (case 3) revealed Kaposi sarcoma (KS). Furthermore, KS was found at autopsy in several other organs in case 3. While the tumor morphology of the lymph nodes, the oral mucosal membrane, and the internal organs was identical to that of classical KS, the skin lesions appeared different. Macroscopically, the skin lesions in case 1 and 3 were alike, but microscopically, the lesions in the two cases differed from each other. In both cases small tumor infiltrates were dispersed in the dermis with interjacent preserved dermal tissue. In case 1 the tumor infiltrates were composed of different vascular structures including irregular slits formed by dermal collagen fibres lined with long slim tumor cells. In case 2 the infiltrates were mainly composed of solid collections of pale tumor cells with faintly stained nuclei. The difficulties in establishing a diagnosis of KS on skin biopsies from patients with AIDS are emphasized.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
7/12. Histiocytoid hemangioma with features of angiolymphoid hyperplasia and Kaposi's sarcoma. A study by light microscopy, electron microscopy, and immunologic techniques.We examined by light and electron microscopy 99 vascular lesions removed on 17 occasions over a 2-year period from a 55-year-old black man. The lesions all showed histologic features of a vascular neoplasm composed of enlarged "histiocytoid" endothelial cells and overlapping features of angiolymphoid hyperplasia with eosinophilia and Kaposi's sarcoma. An apparently unique feature was early loss of melanin from the overlying epidermis and a mononuclear inflammatory-cell infiltrate. The patient also had an abnormal immunologic state very similar to that seen in homosexuals with Kaposi's sarcoma.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
8/12. Bowenoid changes in Kaposi's sarcoma.BACKGROUND: Previous reports have documented the coexistence of multiple infectious organisms or Kaposi's sarcoma within the same biopsy specimens of mucocutaneous lesions in human immunodeficiency virus- (hiv) infected patients. OBJECTIVE: A 31-year-old black man with the acquired immunodeficiency syndrome (AIDS) who had Bowenoid changes and Kaposi's sarcoma within the same cutaneous lesion is described. methods: Microbiologic cultures, microscopic examination, and polymerase chain reaction were performed on a lesional skin biopsy specimen to evaluate for infectious organisms, histopathology, and the presence of human papillomavirus (HPV) deoxyribonucleic acid (dna), respectively. RESULTS: bacteria, fungi, and mycobacteria were not detected with special stains and cultures. The histologic findings were consistent with bowen's disease in the epidermis and patch stage Kaposi's sarcoma in the dermis. There was no polymerase chain reaction product generated from the HPV-specific primers in two individual polymerase chain reaction assays. CONCLUSION: The possibility that coexisting infectious or neoplastic disorders, or both, may be present within a single mucocutaneous lesion should always be considered when evaluating a lesion from an hiv seropositive individual.- - - - - - - - - - ranking = 2keywords = dermis (Clic here for more details about this article) |
9/12. Familial Kaposi's sarcoma.Familial cases of Kaposi's sarcoma are exceedingly rare. We identified an 85-year-old man with Kaposi's sarcoma. Multiple lesions were present on the feet. Previously, the man's 84-year-old sister presented with similar lesions on the lower extremity. Both siblings were lifelong residents of the united states and were of English/German descent. Neither had risk factors for infection with human immunodeficiency virus (hiv). On histologic examination, lesions in both patients demonstrated vascular slits, hemorrhage, and dense aggregates of spindle cells within the dermis.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
10/12. Bullous lesions in Kaposi's sarcoma: case report.Bullous lesions have been only rarely described in Kaposi's sarcoma (KS), and their histopathologic features have never been described in detail. We report a case of bullous lesions of KS in an 82-year-old Italian woman. The patient had typical smooth pale reddish-grey slightly-raised KS plaques on the legs, present for at least 10 years. Several dull grayish-pink blisters (0.5 to 2 cm in diameter) affected both dorsa of her feet and ankles symmetrically. Two punch biopsies were taken, one from an infiltrated KS plaque on the right buttock and the other from a bullous lesion on the right foot. Histopathologically, the late KS plaque on the buttock showed typical features of KS, with an increased number of spindle cells arranged in short bundles and extravasation of erythrocytes. The bullous lesion on the foot showed a full-thickness vascular neoplasm involving the upper and lower dermis and the subcutaneous fat. The upper portion of the lesion contained many newly formed, highly-dilated blood vessels, touching the overlying epidermis and separated from it by a narrow band of collagen and endothelial cells; wide, empty spaces characterized the superficial dermis, in which preexisting venules and bands of collagen associated with non-atypical endothelial cells floated. All these findings would suggest a lymphangiomatous lesion, if the presence of specific diagnostic criteria of KS were not recognizable at a deeper level of the lesion. Various criteria actually suggest that the bullous lesion may be regarded as an epiphenomenon of a KS plaque lesion: (a) full-thickness involvement of the reticular dermis and, in this case, also of the subcutaneous fat; (b) dense and patchy lymphoplasmocytic infiltrate typical of plaque lesions and, much less frequently, of patch lesions; (c) presence of ectatic blood vessels, filled with plasma and erythrocytes (pseudoangiomatous findings), a nonpathognomonic but highly characteristic finding of the plaque lesion; and (d) as in the KS plaque lesions, in the bullous lesion as well the reticular dermis was characterized by an increased number of anastomosing bizarrely shaped vascular spaces lined by non-atypical endothelial cells. We hypothesize that the prevalence of lymphangiomatous differentiation in the upper dermis represents one of the many features of KS lesions. When present, it may correlate with the clinical feature of a blister.- - - - - - - - - - ranking = 6keywords = dermis (Clic here for more details about this article) |
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