Trends in the Incidence of Kaposi's Sarcoma and Non-Hodgkin Lymphoma in Northern Thailand during the Time Period of Universal Access to Antiretroviral Treatment, 1998-2017.

PURPOSE: We evaluated the trends in incidence of Kaposi's sarcoma (KS) and Non-Hodgkin's lymphoma (NHL)  over the two decades in northern Thailand during which access to antiretroviral treatments (ART) in Thailand was scaled up. METHODS: This is retrospective observational study. Data from 1998 to 2017 of patients diagnosed with KS and NHL from three long-standing, population-based cancer registries in northern Thailand (Chiang Mai, Lampang and Lamphun) were used to describe trends in age-adjusted incidence rate (ASR) of these cancers. The annual percent change (APC) of incidence rates were evaluated over this timeframe. RESULTS: The incidence of KS significantly increased from 1998 to 2017 in males (APC of 6.9%) and very low incidence for evaluating change in female. NHL incidence significantly increased from 1998 to 2017, 2.2% and 1.8% per year in males and females, respectively (p<0.001). CONCLUSION: In the last two decades, the incidence of KS in male and NHL in both sexes have increased in northern Thailand, while the incidence of KS in female remained low. The change in incidences in opposite to the decline in HIV prevalence and increase ART coverage rate supported that other associated factors attributable to the development of KS and NHL should be looked for i.e., environmental, occupational exposures and other infections.

The Kaposi's sarcoma progenitor enigma: KSHV-induced MEndT-EndMT axis.

Endothelial-to-mesenchymal transition has been described in tumors as a source of mesenchymal stroma, while the reverse process has been proposed in tumor vasculogenesis and angiogenesis. A human oncogenic virus, Kaposi's sarcoma herpes virus (KSHV), can regulate both processes in order to transit through this transition 'boulevard' when infecting KS oncogenic progenitor cells. Endothelial or mesenchymal circulating progenitor cells can serve as KS oncogenic progenitors recruited by inflammatory cytokines because KSHV can reprogram one into the other through endothelial-to-mesenchymal and mesenchymal-to-endothelial transitions. Through these novel insights, the identity of the potential oncogenic progenitor of KS is revealed while gaining knowledge of the biology of the mesenchymal-endothelial differentiation axis and pointing to this axis as a therapeutic target in KS.

Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio / El desarrollo del sarcoma de Kaposi oral está asociado con carga viral de VIH, recuento de CD4+ y relación CD4+/CD8+

Background: Kaposi’s sarcoma (KS) is an uncommon, multifocal and angioproliferative lesion, which demon-strates a poor prognosis. The aim of the present research was to explore the association of HIV viral load, CD4+and CD8+ counts and the CD4+/CD8+ ratio on the risk of oral Kaposi’s sarcoma (KS) development.Material and Methods: A total of 62 patients were retrieved from March 2008 to October 2020 from the files oftwo oral pathology centres. Clinical, laboratory and follow-up data were retrieved from their medical files. Poissonregression was used to explore the role of history of immunosuppression and its association with oral KS develop-ment. A P-value <0.05 was considered significant.Results: Sixty-two patients were included in the present study (32 with oral KS and 30 with no presentation oflesions anywhere on the body). Patients with oral KS presented a mean age of 32.6 years, and male patients weremore affected. The hard palate (15 cases; 46.8%) was the main anatomical site affected. The lesions were mostlypresented as swellings (13 cases; 40.6%) and nodules (12 cases; 37.5%). Systemic manifestations were also ob-served, including candidiasis (4 cases; 12.5%), bacterial infection (3 cases; 9.3%), tuberculosis (3 cases; 9.3%),herpes simplex (3 cases; 9.3%) and pneumonia (3 cases; 9.3%). A significant correlation was observed betweenHIV viral load, CD4+ count and the CD4+/CD8+ ratio with oral KS development.Conclusions: HIV viral load, CD4+ count and the CD4+/CD8+ ratio are associated with oral KS development.(AU)

Hemorragia digestiva alta por Sarcoma de Kaposi en paciente con VIH-SIDA / Upper gastrointestinal bleeding due to Kaposi´s Sarcoma in HIV-AIDS patient

Gastrointestinal bleeding related to Kaposi’s Sarcoma is rare in AIDS patients; the etiology of anemia is usually multifactorial. We describe the case of a HIV infected, 53 year old patient with refractory anemia requiring frequent transfusion support. He was a patient with multiple complications and recent introduction of drugs that could justify myelosuppression and anemia. Due to inconclusive endoscopic examinations, the appearance of melena was the clue of the investigation, which concluded in the diagnosis of duodenal Kaposi’s Sarcoma. (AU)

Successful treatment of pediatric post-liver transplant Kaposi`s sarcoma with paclitaxel.

BACKGROUND: Kaposi`s sarcoma (KS) is a complication of immunosuppressive therapy for transplant recipients. Unlike adult recipients, KS in pediatric organ transplantation is quite rare. Treatment is usually withdrawal of immunosuppression; non-responders often receive chemotherapy. CASE: We have reported a child with post-liver transplant visceral KS which has progressed despite withdrawal of immunosuppressive therapy, who has been treated with Paclitaxel for three weeks. KS has regressed completely after four cycles of Paclitaxel. CONCLUSION: Paclitaxel should be considered as an effective first line treatment option for patients with posttransplant KS.

[IAssociation between Kaposi´s sarcoma and multiple myeloma: is it caused by HHV-8?] / Sarcome de kaposi et myélome multiple: s´agit-il d´une association causée par le HHV-8?

Kaposi´s sarcoma is a tumor characterized by purple or brownish lesions affecting the skin. It is most commonly associated with human herpes virus type 8 (HHV-8) infection and may be secondary to malignant hemopathy, including lymphomas. We here report a new case of a very rare combination: Kaposi´s disease-multiple myeloma. The study involved Mr. aged 67 years, treated for Kaposi´s disease in the Department of Dermatology. Serological test for HHV-8 was positive; it was associated with stage I multiple myeloma IgG Lambda with a poor prognosis. We here report this 21st case of Kaposi-Kahler in order to highlight Kaposi-human herpes 8 virus variant involved in the pathophysiology of multiple myeloma. More studies are needed in order to establish this exceptional link.

KSHV LANA acetylation-selective acidic domain reader sequence mediates virus persistence.

Viruses modulate biochemical cellular pathways to permit infection. A recently described mechanism mediates selective protein interactions between acidic domain readers and unacetylated, lysine-rich regions, opposite of bromodomain function. Kaposi´s sarcoma (KS)-associated herpesvirus (KSHV) is tightly linked with KS, primary effusion lymphoma, and multicentric Castleman's disease. KSHV latently infects cells, and its genome persists as a multicopy, extrachromosomal episome. During latency, KSHV expresses a small subset of genes, including the latency-associated nuclear antigen (LANA), which mediates viral episome persistence. Here we show that LANA contains two tandem, partially overlapping, acidic domain sequences homologous to the SET oncoprotein acidic domain reader. This domain selectively interacts with unacetylated p53, as evidenced by reduced LANA interaction after overexpression of CBP, which acetylates p53, or with an acetylation mimicking carboxyl-terminal domain p53 mutant. Conversely, the interaction of LANA with an acetylation-deficient p53 mutant is enhanced. Significantly, KSHV LANA mutants lacking the acidic domain reader sequence are deficient for establishment of latency and persistent infection. This deficiency was confirmed under physiological conditions, on infection of mice with a murine gammaherpesvirus 68 chimera expressing LANA, where the virus was highly deficient in establishing latent infection in germinal center B cells. Therefore, LANA's acidic domain reader is critical for viral latency. These results implicate an acetylation-dependent mechanism mediating KSHV persistence and expand the role of acidic domain readers.

Sarcoma de kaposi en pacientes vih: a proposito de dos casos / Kaposi´s sarcoma in hiv patients: regarding two case report

RESUMEN: El Sarcoma de Kaposi es unaneoplasia de origen vascular,asociado obligadamente al virus Herpes Humano tipo 8. Presenta manifestaciones cutáneas en primer lugar, mucosas, ganglionares y viscerales. Puede evolucionar de forma leve con lesiones cutáneas, hasta casos fulminantes con compromiso sistémico, en caso de no realizar tratamiento. Existen múltiples opciones terapéuticas, las cuales se definen según el compromiso de la enfermedad y la afectación del paciente por su patología de base.El diagnóstico se basa en la sospecha clínica y se confirma con una biopsia histopatológica. El sarcoma de Kaposi corresponde a la neoplasia más frecuente en los pacientes con VIHse encuentraprincipalmente en hombres homosexuales. En este artículo se presentan dos pacientes con VIH con diagnóstico de Sarcoma de Kaposi y se realiza una breve revisión de la bibliografía.

ABSTRACT: Kaposi´s sarcoma is a vascular origin neoplasm, obligatory associated with Human Herpes Virus 8. It presents cutaneous manifestations at a first place, mucous, ganglionic and viscerals. It may present a mild presentation with cutaneous manifestations, up to fulminant cases with systemicinvolvement,in case of not being treated. There are a number of therapeutic options, defined by the state of the illness and the involvement of the patient due to the primary pathology. The diagnosis is based on the clinical suspicion and it is confirmed by a histopathological biopsy. Kaposi´s sarcomais the most frequent neoplasm in patients with HIV, being more frequently in homosexual men. In this article two HIV patients with Kaposi´s sarcoma diagnosis are exposed and a brief revision of the literature is done.

Therapeutic Outcomes in AIDS-Associated Kaposi's Sarcoma Patients on Antiretroviral Therapy Treated with Chemotherapy at Two Tertiary Hospitals in Lusaka, Zambia.

The incidence of HIV-associated Kaposi's sarcoma (KS) remains high in Zambia in the antiretroviral therapy era. The most efficacious treatment regimen for KS has yet to be established. In both developed and developing countries, treatment regimens have had limited efficacy. Late presentation in Africa affects therapeutic outcomes. OBJECTIVE: The aim of this study was to determine therapeutic outcomes of epidemic KS patients on combination antiretroviral therapy (cART) after completion of six cycles of Adriamycin, Bleomycin, and Vincristine (ABV) chemotherapy. METHODS: This was a descriptive cross-sectional study. Study participants were drawn from a study database of confirmed incident KS patients seen at the Skin Clinic of the University Teaching Hospitals (UTH) during the period between August, 2015 and September, 2016. RESULTS: Of the 38 successfully recruited study participants, a complete response was documented in 18 (47%) after 6 cycles of ABV whereas 20 (53%) experienced a partial response. KS recurrence was observed in 8 (44%) of the individuals that experienced an initial complete response. At the time of the study, clinical assessment revealed that KS lesions had completely regressed in 21 (55%) of all the patients. CONCLUSION: ABV chemotherapy appears ineffective in long-term resolution of epidemic KS patients on ART. Recurrence rates are high after chemotherapy in patients that experience initially favorable responses to treatment. There is a need to diagnose KS earlier, and to develop more efficacious treatment options in order to reduce recurrence rates for epidemic KS.

Detection of Human Herpes Virus 8 in Kaposi's sarcoma tissues at the University Teaching Hospital, Lusaka, Zambia.

INTRODUCTION: Human herpes virus-8, a γ2-herpes virus, is the aetiological agent of Kaposi sarcoma. Recently, Kaposi's sarcoma cases have increased in Zambia. However, the diagnosis of this disease is based on morphological appearance of affected tissues using histological techniques, and the association with its causative agent, Human Herpes virus 8 is not sought. This means poor prognosis for affected patients since the causative agent is not targeted during diagnosis and KS lesions may be mistaken for other reactive and neoplastic vascular proliferations when only histological techniques are used. Therefore, this study was aimed at providing evidence of Human Herpes virus 8 infection in Kaposi's sarcoma tissues at the University Teaching Hospital in Lusaka, Zambia. METHODS: One hundred and twenty suspected Kaposi's sarcoma archival formalin-fixed paraffin-wax embedded tissues stored from January 2013 to December 2014 in the Histopathology Laboratory at the University Teaching Hospital, Lusaka, Zambia were analysed using histology and Polymerase Chain Reaction targeting the ORF26 gene of Human Herpes virus 8. RESULTS: The predominant histological type of Kaposi's sarcoma detected was the Nodular type (60.7%) followed by the plaque type (22.6%) and patch type (16.7%). The nodular lesion was identified mostly in males (40.5%, 34/84) than females (20.2%, 17/84) (p=0.041). Human Herpes virus 8 DNA was detected in 53.6% (45/84) and mostly in the nodular KS lesions (60%, 27/84) (p=0.035). CONCLUSION: The findings in this study show that the Human Herpes virus-8 is detectable in Kaposi's sarcoma tissues, and, as previously reported in other settings, is closely associated with Kaposi's sarcoma. The study has provided important baseline data for use in the diagnosis of this disease and the identification of the virus in the tissues will aid in targeted therapy.

Sarcoma de Kaposi por dosis altas de esteroides / Kaposi´s sarcoma due to high dose of steroids

Se describe el caso clínico de una paciente de 42 años de edad, quien necesitó tratamiento reiterado con prednisona y a partir de entonces comenzó a presentar lesiones cutáneas en ambas piernas. Luego de ser valorada por especialistas en reumatología y dermatología fue remitida al Servicio de Angiología, donde se le realizó biopsia (con el uso de la coloración de hematoxilina-eosina), cuyos resultados fueron compatibles con un sarcoma de Kaposi, atribuible al suministro de esteroides.

The case report of a 42 years patient is described who needed repeated treatment with prednisone and from that time on she began to present cutaneous lesions in both legs. After being evaluated by reumatology and dermatology specialists, she was referred to the Angiology Service, where a biopsy was taken (with the use of the hematoxylin-eosine stain) which results were compatible with a Kaposi´s sarcoma, attributable to steroids supply.

Sarcoma de Kaposi en conjuntiva bulbar / Kaposi´s sarcoma in bulbar conjunctiva

Paciente masculino de 29 años de edad, raza blanca, soltero, profesor universitario, con antecedentes de padecer crisis de epilepsia tratado con fenitoína y actualmente controlado, menciona que desde hace aproximadamente 4 semanas comenzó con ojo rojo y molestias oculares del ojo derecho, por lo cual acudió a su área de salud donde fue tratado como cuadro de conjuntivitis. No mostró mejoría alguna, sino empeoramiento del cuadro clínico, y observó un enrojecimiento ocular intenso en el ángulo interno de dicho ojo que se fue extendiendo, acompañado de ligera fotofobia. Por la tórpida evolución del cuadro decidió acudir a nuestra institución por lo cual fue remitido a la Consulta de Oculoplastia. También refirió que desde hacía dos meses había presentado anorexia, dificultad al comer, así como pérdida de peso, por lo cual se decidió comenzar estudio y tratamiento. Se decidió realizar la resección de la masa tumoral en conjuntiva bulbar y se envió para estudio anatomopatológico. El resultado fue compatible con un sarcoma de Kaposi(AU)

A twenty-nine years-old male Caucasian patient, single and university professor, with a history of epilepsy treated with fenitoin and managed at present. He stated that 4 weeks ago approximately, he began feeling ocular discomfort in addition to reddened eye, so he went to his health area where he was treated as a conjunctivitis case. No improvement occurred, the clinical picture worsened and there was intensive ocular reddening in the internal angle of the eye that extended and mild photofobia. Because of the rapid profession of the clinical picture, he decided to go to our institution where he was referred to the Oculoplasty Service. He also said that he had been suffering anorexia, difficulties to eating and weight loss two months ago. It was then decided to start the study and treatment of this case. First, the tumor mass from the bulbar conjunctiva was resected and then sent to anatomical pathological study service. The result was compatible with Kaposi´s sarcoma diagnosis(AU)

Sarcoma de Kaposi en conjuntiva bulbar / Kaposi´s sarcoma in bulbar conjunctiva

Paciente masculino de 29 años de edad, raza blanca, soltero, profesor universitario, con antecedentes de padecer crisis de epilepsia tratado con fenitoína y actualmente controlado, menciona que desde hace aproximadamente 4 semanas comenzó con ojo rojo y molestias oculares del ojo derecho, por lo cual acudió a su área de salud donde fue tratado como cuadro de conjuntivitis. No mostró mejoría alguna, sino empeoramiento del cuadro clínico, y observó un enrojecimiento ocular intenso en el ángulo interno de dicho ojo que se fue extendiendo, acompañado de ligera fotofobia. Por la tórpida evolución del cuadro decidió acudir a nuestra institución por lo cual fue remitido a la Consulta de Oculoplastia. También refirió que desde hacía dos meses había presentado anorexia, dificultad al comer, así como pérdida de peso, por lo cual se decidió comenzar estudio y tratamiento. Se decidió realizar la resección de la masa tumoral en conjuntiva bulbar y se envió para estudio anatomopatológico. El resultado fue compatible con un sarcoma de Kaposi(AU)

A twenty-nine years-old male Caucasian patient, single and university professor, with a history of epilepsy treated with fenitoin and managed at present. He stated that 4 weeks ago approximately, he began feeling ocular discomfort in addition to reddened eye, so he went to his health area where he was treated as a conjunctivitis case. No improvement occurred, the clinical picture worsened and there was intensive ocular reddening in the internal angle of the eye that extended and mild photofobia. Because of the rapid profession of the clinical picture, he decided to go to our institution where he was referred to the Oculoplasty Service. He also said that he had been suffering anorexia, difficulties to eating and weight loss two months ago. It was then decided to start the study and treatment of this case. First, the tumor mass from the bulbar conjunctiva was resected and then sent to anatomical pathological study service. The result was compatible with Kaposi´s sarcoma diagnosis(AU)

Tres variedades de sarcoma de Kaposi con compromiso gastrointestinal / Three varieties of Kaposi’s sarcoma with gastrointestinal involvement

Se presentan casos de 4 pacientes adultos con 3 variedades de sarcoma de Kaposi: epidémico (asociado con infección por virus de inmunodeficiencia humana), iatrogénico (en paciente con inmunosupresión crónica y en un hombre con cirrosis alcohólica) y clásico (en paciente anciana sin inmunosupresión conocida); todos ellos presentaron compromiso gastrointestinal. Se hace una breve revisión de esta enfermedad.

This article presents the cases of four adult patients with three varieties of Kaposi’s sarcoma: epidemic, associated with human immunodeficiency virus infections; iatrogenic, associated with chronic immune suppression (and in this case in a man with alcoholic cirrhosis); and classic, occurring in elderly patient without previously known immunosuppression. All four cases had gastrointestinal involvement. A brief review of the disease is included.

Sarcoma de Kaposi. Una revisión / Kaposi's sarcoma

El Sarcoma de Kaposi es un tumor vascular de la piel, más frecuente en hombres mayores de 50 años, de larga evolución y baja mortalidad. Cada día cobran mayor interés los elementos epidemiológicos, como su relación con el SIDA (aumento de incidencia en jóvenes y niños, con una agresividad no habitual) y con la inmunosupresión en pacientes transplantados. Se atribuye una fuerte relación del Herpesvirus 8 como uno de los factores etiopatogénicos, y el tratamiento se ha reorientado en base a estos, pero aún no existe una terapia 100 por ciento eficaz.

A bibliographic review was done on Kaposi's sarcoma with the purpose of updating this topic, mainly in relation to its etiopathogenic aspects and therapeutic behavior. Kaposi's sarcoma is a vascular tumor of the skin, most frequently seen in men over 50 years, which develops throughout many years, rarely causing death. Its epidemiological elements have greater significance each day, such as its relation to AIDS and immunosuppresion in kidney transplants, as well as other organs.In the past years it has been observed worldwide in young patients, even children, with an unusual aggressiveness, more lesions and dissemination in the body, due to its relation to AIDS. A strong relation to Herpesvirus 8 is considered as one of the etiopathogenic factors, and treatment has been changed accordingly, but there is no 100 percent effective therapy.

Sarcoma de Kaposi associado a corticoterapia sistêmica / Kaposi sarcoma associated with systemic corticosteroid therapy

Sarcoma de Kaposi é uma neoplasia angioproliferativa de origem mesenquimal com acometimento cutâneo frequente. Encontra-se relacionado a doenças infecciosas ou a condições que envolvam imunossupressão. O objetivo deste trabalho é descrever um caso de sarcoma de Kaposi disseminado iatrogênico, em paciente usuária crônica de corticosteroide. Embora, atualmente, o sarcoma de Kaposi seja relacionado principalmente à síndrome da imunodeficiência adquirida, é importante destacar seu comportamento crescente como malignidade oportunista em pacientes em uso de imunossupressores, particularmente, corticosteróide

Kaposi’s sarcoma is a mesenchymal angioproliferative neoplasm with frequent cutaneous involvement. It is related to infectious diseases or conditions involving immunosuppression. The aim of this paper is to describe a case of disseminated iatrogenic Kaposi’s sarcoma in a female patient under corticosteroid therapy. Although currently Kaposi’s sarcoma is related primarily to the Acquired Immunodeficiency Syndrome, it is important to highlight its growing presence as an opportunistic malignancy in patients taking immunosuppressive drugs, particularly corticosteroids

Manifestaciones clínicas y evaluación diagnóstica en el Sarcoma de Kaposi / Clinical features and diagnostic evaluation in Kaposi´s sarcoma

El Sarcoma de Kaposi (SK) es una causa de compromiso respiratorio en el VIH/SIDA, que clásicamente ha indicado un pronóstico desfavorable. Esta definición está modificándose,según la extensión y alcance de los tratamientos actuales con antiretrovirales (HAART). Se exponen los rasgos clínicos y los recursos diagnósticos empleados en dos pacientesasistidos en nuestro hospital universitario. Las lesiones mucocutáneas generalizadas, los patrones característicos de tomografía computada de alta resolución (TCAR) junto a los hallazgos fibrobroncoscópicos (FBC) son descriptos en ambos casos. Se discuten los diagnósticos diferenciales para neoplasias e infecciones oportunistas, con la correspondiente revisión bibliográfica.

Kaposi´s sarcoma (KS) is considered one of the most severe manifestations related to lung involvement in HIV/AIDS. Present therapy with HAART has modified the incidence and prognosis of Kaposi´s sarcoma. However, KS is still a prevalent condition in HIV/AIDS patients. Clinical features, diagnostic patterns from High Resolution Computed Tomography (HRCT), and bronchofibroscopy findings are described in two patients.Differential diagnosis for main conditions in the AIDS clinical context (malignant neoplasm, opportunistic infections) is discussed with a review of previous reports.

Sarcoma de Kaposi: a propósito de un caso clínico, actualización del tema / Kaposi 's sarcoma: a case report, update on the topic

El sarcoma de Kaposi (KS por sus siglas en inglés) es una enfermedad similar al cáncer. Se relaciona con la infección del VIH, y se presenta en estadios avanzados de la enfermedad, afectando el 20% de las personas con VIH que no toman medicamentos antirretrovirales. En Pinar del Río existe una baja incidencia de infección por VIH/SIDA. Dada la infrecuencia del Sarcoma de Kaposi se presenta un caso. Paciente de 50 años de edad, que después de un cuadro de dolor en epigastrio comienza con lesiones en la piel similares a hematoma en resolución, con centro más oscuro y nodular, que toman prácticamente todo el cuerpo. El paciente presenta ligera pérdida de peso, pero no prurito, no fiebre, no lesiones en mucosa oral. Se determinó Hb: 112g/l Hto: 0.34l/l Leucocitos: 4.4x10(9)/l. Se encontró aumento de células mononucleares en el diferencial con linfopenia asociada; velocidad de sedimentación, colesterol, transaminasas, función renal y proteínas totales, normales, pero trombocitopenia moderada, acido úrico elevado. En el aspirado medular aparece predominio de linfocitos atípicos, con depresión relativa de las series hematopoyéticas. Gastroscopia, negativa. Biopsia de piel: Compatible con Sarcoma de Kaposi. VIH: tres exámenes durante el estudio con tiempo de intervalo entre ellos 3 meses desde el inicio resultaron negativos. Último examen viral a los 7 meses de iniciado el estudio (positivo) con Western Blot.

Kaposi´s Sarcoma (KS) is a cancer-like disease. It is most frequent related to HIV infection, present in late stages of the disease and affecting 20 % of HIV infected people having no Highly Active Antiretroviral Therapy (HAART). Since in Pinar del Rio Province a low incidence rate of HIV/AIDS is observed , Kaposi´s Sarcoma is very infrequent. A 50 year-old male who after presenting an epigastralgia suffers from hematoma-like skin lesions, in resolution and when palpated the darker center was nodular. These lesions take practically the whole body, observing loss of weight, no fever, no itching, no oral mucosa lesions. Determining Hb: 112 g/l, Hto; 0.34/L, Leukocytes: 4.4 x 4x10(9)/l, increase of mononuclear cells, associated to lymphopenia, but erythrocyte sedimentation rate, seric cholesterol, transaminases, kidney function and total proteins were normal. Moderated thrombocytopenia and high levels of uric acid were observed. In the bone marrow aspiration atypical lymphocytes and relative depression of the hematopoietic series prevailed. Gastroscopy was negative. Skin biopsy: Compatible with Kaposi´s Sarcoma. HIV: three exams during the study at 3 months intervals being negative from the beginning. The last viral examination carried out at 7 months after the beginning of the study resulted positive when Western Blot technique was used.

A Case of Gastric Kaposi's Sarcoma Successfully Treated with VP-16 / 대한소화기내시경학회지

Kaposi's sarcoma, a rare tumor, usually presents itself with skin lesions. However, extracutaneous lesions are common and the gastrointestinal tract is often involved. Gastric Kaposi's sarcoma is usually asymptomatic, but may cause massive gastrointestinal hemorrhage, perforation, intestinal obstruction, intussusception, protein-losing enteropathy, or sepsis. The gastroscopic appearances of Kaposi's sarcoma range from reddish purple maculopapules to polypoid, umbilicated nodules. In Korea, only one case of gastric Kaposi's sarcoma had been reported until now. A case of gastric Kaposi's sarcoma treated with VP-16 (etoposide) is here in reported with the endoscopic findings before and after chemotherapy.