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Histological variants of cutaneous Kaposi sarcoma.

Grayson W, Pantanowitz L - Diagn Pathol (2008)

Bottom Line: This review provides a comprehensive overview of the broad clinicopathologic spectrum of cutaneous Kaposi sarcoma (KS) lesions.Variants discussed include: usual KS lesions associated with disease progression (i.e. patch, plaque and nodular stage); morphologic subtypes alluded to in the older literature such as anaplastic and telangiectatic KS, as well as several lymphedematous variants; and numerous recently described variants including hyperkeratotic, keloidal, micronodular, pyogenic granuloma-like, ecchymotic, and intravascular KS.Involuting lesions as a result of treatment related regression are also presented.

View Article: PubMed Central - HTML - PubMed

Affiliation: Histopathology Department, Ampath National Laboratory Support Services, Johannesburg, South Africa. wayne.grayson@live.com

ABSTRACT
This review provides a comprehensive overview of the broad clinicopathologic spectrum of cutaneous Kaposi sarcoma (KS) lesions. Variants discussed include: usual KS lesions associated with disease progression (i.e. patch, plaque and nodular stage); morphologic subtypes alluded to in the older literature such as anaplastic and telangiectatic KS, as well as several lymphedematous variants; and numerous recently described variants including hyperkeratotic, keloidal, micronodular, pyogenic granuloma-like, ecchymotic, and intravascular KS. Involuting lesions as a result of treatment related regression are also presented.

No MeSH data available.


Related in: MedlinePlus

Patch stage Kaposi sarcoma showing newly formed vessels protruding into a larger vascular space characteristic of the promontory sign (H&E stain).
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Figure 1: Patch stage Kaposi sarcoma showing newly formed vessels protruding into a larger vascular space characteristic of the promontory sign (H&E stain).

Mentions: Patch stage KS, which represents the earliest phase in the evolution of cutaneous KS, is perhaps the histologic variant with the greatest propensity to cause diagnostic difficulties for the unwary. The initial low-power impressions are those of a "busy" dermis, or perhaps some form of mild inflammatory dermatosis [1,13]. On closer examination, however, there are signs of a subtle vasoformative process composed of newly formed slit-like or somewhat jagged vascular spaces, which tend to be more conspicuous in the immediate vicinity of native dermal vessels and cutaneous appendages [1-4]. The protrusion of these native microscopic vascular structures into the lumens of more ectatic neoplastic channels results in the characteristic promontory sign (Figure 1). The intervening dermis frequently reveals dissection of its collagen bundles by slit-like vascular spaces lined by a monolayer of relatively banal, flattened endothelial cells, with a variable degree of erythrocyte extravasation. The newly formed channels often contain red blood cells. There is also a noticeable mild background inflammatory cell infiltrate comprising lymphocytes and plasma cells, often accompanied by a contingent of hemosiderin-laden macropahges. The aforementioned mononuclear cells tend to be concentrated around the native vessels and skin adnexal structures [1-4].


Histological variants of cutaneous Kaposi sarcoma.

Grayson W, Pantanowitz L - Diagn Pathol (2008)

Patch stage Kaposi sarcoma showing newly formed vessels protruding into a larger vascular space characteristic of the promontory sign (H&E stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2526984&req=5

Figure 1: Patch stage Kaposi sarcoma showing newly formed vessels protruding into a larger vascular space characteristic of the promontory sign (H&E stain).
Mentions: Patch stage KS, which represents the earliest phase in the evolution of cutaneous KS, is perhaps the histologic variant with the greatest propensity to cause diagnostic difficulties for the unwary. The initial low-power impressions are those of a "busy" dermis, or perhaps some form of mild inflammatory dermatosis [1,13]. On closer examination, however, there are signs of a subtle vasoformative process composed of newly formed slit-like or somewhat jagged vascular spaces, which tend to be more conspicuous in the immediate vicinity of native dermal vessels and cutaneous appendages [1-4]. The protrusion of these native microscopic vascular structures into the lumens of more ectatic neoplastic channels results in the characteristic promontory sign (Figure 1). The intervening dermis frequently reveals dissection of its collagen bundles by slit-like vascular spaces lined by a monolayer of relatively banal, flattened endothelial cells, with a variable degree of erythrocyte extravasation. The newly formed channels often contain red blood cells. There is also a noticeable mild background inflammatory cell infiltrate comprising lymphocytes and plasma cells, often accompanied by a contingent of hemosiderin-laden macropahges. The aforementioned mononuclear cells tend to be concentrated around the native vessels and skin adnexal structures [1-4].

Bottom Line: This review provides a comprehensive overview of the broad clinicopathologic spectrum of cutaneous Kaposi sarcoma (KS) lesions.Variants discussed include: usual KS lesions associated with disease progression (i.e. patch, plaque and nodular stage); morphologic subtypes alluded to in the older literature such as anaplastic and telangiectatic KS, as well as several lymphedematous variants; and numerous recently described variants including hyperkeratotic, keloidal, micronodular, pyogenic granuloma-like, ecchymotic, and intravascular KS.Involuting lesions as a result of treatment related regression are also presented.

View Article: PubMed Central - HTML - PubMed

Affiliation: Histopathology Department, Ampath National Laboratory Support Services, Johannesburg, South Africa. wayne.grayson@live.com

ABSTRACT
This review provides a comprehensive overview of the broad clinicopathologic spectrum of cutaneous Kaposi sarcoma (KS) lesions. Variants discussed include: usual KS lesions associated with disease progression (i.e. patch, plaque and nodular stage); morphologic subtypes alluded to in the older literature such as anaplastic and telangiectatic KS, as well as several lymphedematous variants; and numerous recently described variants including hyperkeratotic, keloidal, micronodular, pyogenic granuloma-like, ecchymotic, and intravascular KS. Involuting lesions as a result of treatment related regression are also presented.

No MeSH data available.


Related in: MedlinePlus