Kaposi肉瘤临床形态与组织学的相关性（附2例光镜,电镜观察）

对２例Ｋａｐｏｓｉ肉瘤的临床形态与组织学进行了相关性研究，描述了斑片、斑块和结节这三种Ｋａｐｏｓｉ肉瘤基本皮损的临床、组织学和超微结构特点，斑片损害以非特异性炎症表现为主，斑块和结节损害则主要以小血管和梭形细胞增生为主，并就这三种临床形态皮损组织学和超微结构特点进行了讨论。     

HIV/AIDS相关型卡波西肉瘤1例

卡波西肉瘤大致可分为4型:经典型、非洲型、HIV/AIDs相.关型及免疫抑制相关型,其中HIVIAIDS相关型卡波西肉瘤病程进展迅速,预后差.我科近日诊治1例HIV/AIDS相关型卡波西肉瘤,并出现多脏器受损,现报告如下.     

假性卡波西肉瘤1例

假性卡波西肉瘤指异常血流所致的表浅血管局限性增生,包括一组皮损类似于卡波西肉瘤的斑块和结节的疾病,该病比较少见。笔者最近发现1例因左上臂置入动脉支架术后发生的假性卡波西肉瘤,现报道如下。     

H IV 相关型卡波西肉瘤2例并文献复习

报告2例HIV相关型卡波西肉瘤并进行相关文献复习。病例1,患者女,38岁,非洲裔,双手背、小腿紫红色丘疹5月,无明显痒痛感,体检：双手背、小腿散在1～5 mm大小紫红色丘疹。病例2,患者男,46岁,中国汉族,双下肢、右眼睑紫褐色丘疹、结节1年,体检：双下肢、右眼睑多处皮肤散在1～8 mm大小紫红色或暗褐色丘疹、结节。两患者抗HIV抗体确证试验阳性。皮肤组织病理检查均示：符合卡波西肉瘤。根据临床及皮肤组织病理、HIV检查结果诊断：HIV相关型卡波西肉瘤。     

HIV-1 Tat蛋白促血管生成作用研究进展

Tat蛋白是HIV-1基因组编码的6个调控蛋白中一个重要的调控蛋白,在艾滋病相关卡波西肉瘤的发生发展中起一定作用。本文综述了细胞外HIV-1 Tat蛋白促血管生成作用的最新研究进展,包括Tat不同结构区域在促血管生成中所起的作用,以及与各种生长因子及化学因子之间的相互作用,阐述了Tat促内皮细胞及卡波西肉瘤细胞血管生成的主要机制,为临床开发拮抗Tat的促血管生成作用药物,抑制AIDS相关卡波西肉瘤的发生及发展提供理论依据。     

卡波西肉瘤与HHV—8

1 卡波西肉瘸(Kaposi’s sarcoma,KS) 卡波西肉瘤是一种血管源性肿瘤,又称多发性、特发性出血性肉瘤。自卡波西于1872年报告本病至今已有100余年的历史,有关卡波西肉瘤的病因学一直未能确定。按照Kaposi所描述本病多中心发生,全身皮肤及内脏血管广泛受累,紫色的结节性皮肤皮损。被称为经典的卡波西     

基于网络药理学预测中药在抗卡波西肉瘤血管生成治疗中的潜在有效成分及分子作用机制

【摘要】 目的 基于网络药理学方法分析中药抗卡波西肉瘤血管生成的潜在有效成分及分子作用机制，预测中药在抗卡波西肉瘤血管生成中的关键靶点和信号通路。方法 根据既往网络药理学研究结果，利用中药系统药理学数据库与分析平台（TCMSP）获取虎杖、桑白皮、土茯苓、紫苏子的主要化学成分和靶点；通过GeneCard、OMIM、DrugBank、TTD数据库检索获取血管生成及卡波西肉瘤治疗靶点，构建韦恩图，得到卡波西肉瘤与抗血管生成药物成分相互作用的靶点；利用STRING 11.5平台构建蛋白质互作模型；应用Cytoscape3.6.0软件构建成分-靶点网络，并进行可视化。同时利用Metascape平台对核心靶点进行基因本体（GO）功能富集分析和京都基因与基因组百科全书（KEGG）通路富集分析。最后将得到的主要活性成分和核心靶点进行分子对接验证。结果 抗卡波西肉瘤血管生成药物的核心成分为白藜芦醇［连接度（degree）142］、槲皮素（degree：141）、山柰酚（degree：56）、木樨草素（degree：56）、β-谷甾醇（degree：37）、花生四烯酸（degree：36）、柚皮素（degree：36）等，核心靶点是前列腺素内过氧化物合酶2（PTGS2）。利用KEGG分析筛选出抗卡波西肉瘤血管生成相关的重要通路为癌症信号通路；GO分析显示在生物学过程中靶点主要集中在细胞迁移的正调控。分子对接结果显示白藜芦醇、槲皮素、山柰酚和木樨草素与PTGS2均有较好的亲和力，其中槲皮素和木樨草素与PTGS2结合能力最高，结合能分别为-9.4、-9.5 kcal/mol。结论 本研究表明中医药百科全书数据库所录入的4种中药可能通过调控癌症信号通路，作用于PTGS2等靶点发挥抗血管生成作用，从而预测了中药抗卡波西肉瘤血管生成的可能作用机制。     

经典型卡波西肉瘤的研究进展

经典型卡波西肉瘤(classic kaposi sarcoma,CKS)是卡波西肉瘤(kaposi sarcoma,KS)中最轻微的类型,是一种惰性的皮肤疾病。典型皮损发生于下肢的暗红至紫红色的斑片、斑块,主要影响地中海或者东欧起源的老年男性。国内的相关报道多见于新疆地区,研究表明CKS的发病与HHV-8相关。近年来本病在全世界的发病率逐渐升高。本文对其病因、临床表现、诊断、鉴别诊断及治疗等方面的研究进展进行综述,以提高对该病的认识。     

艾滋病相关型卡波西肉瘤

报告1例以皮肤病变为首发表现的艾滋病相关型卡波西（Kaposi）肉瘤。患者女,40岁。右上臂、胸部、足部出现大小不等的暗红色斑块和结节4个月,咳嗽、咯血2个月。胸部CT示：两肺多发性结节。皮肤组织病理检查示：Kaposi肉瘤（斑块期）。抗HIV抗体（＋）。诊断：艾滋病相关型卡波西肉瘤。     

HIV相关型卡波西肉瘤2例并文献复习

报告2例HIV相关型卡波西肉瘤并进行相关文献复习。病例1,患者女,38岁,非洲裔,双手背、小腿紫红色丘疹5月,无明显痒痛感,体检:双手背、小腿散在1~5 mm大小紫红色丘疹。病例2,患者男,46岁,中国汉族,双下肢、右眼睑紫褐色丘疹、结节1年,体检:双下肢、右眼睑多处皮肤散在1~8 mm大小紫红色或暗褐色丘疹、结节。两患者抗HIV抗体确证试验阳性。皮肤组织病理检查均示:符合卡波西肉瘤。根据临床及皮肤组织病理、HIV检查结果诊断:HIV相关型卡波西肉瘤。     

Lymphangioma-like Kaposi sarcoma

BACKGROUND: Lymphangioma-like Kaposi's sarcoma (LLKS) is a rare morphologic expression of Kaposi's sarcoma (KS) that occurs in virtually all of the well-recognized clinical subtypes of the disease and has the potential to mimic other pathologic processes. In this study, we present the clinical and pathological features of four patients with LLKS. METHODS: Four cases of LLKS were retrieved from the dermatopathology files of our institution. All four tumours were tested immunohistochemically with anti-human herpesvirus-8 (HHV-8) latent nuclear antigen-1 (LNA-1) and anti-CD34 antibodies. RESULTS: Clinically, each patient presented with violaceous patches, papules or plaques; one patient presented with bullous lesions. All of the LLKS biopsy specimens revealed areas with characteristic light microscopic features of KS. Lymphangioma-like foci consisted of ectatic, irregularly shaped vascular spaces lined by mildly atypical endothelial cells. All tumour cells, including those associated with LLKS foci, showed a strong and diffuse reactivity for anti-HHV-8 LNA-1 and anti-CD34. KS progressed slowly in two patients with adequate follow-up. CONCLUSIONS: As LLKS can mimic other disease processes, the correct diagnosis relies heavily on the recognition of salient clinical and histological features of conventional KS, including a strong immunohistochemical expression of HHV-8-associated LNA-1 in lesional cells.     

Kaposi's sarcoma in women: A clinicopathologic study

BACKGROUND: Although all epidemiologic subsets of Kaposi's sarcoma (KS) (i.e., sporadic, endemic, epidemic, and iatrogenic) have an association with human herpes virus 8 (HHV8), these subsets occur in patient populations with distinctive clinical features. To a variable degree men outnumber women in all subsets. OBJECTIVE: A retrospective study of women with histologically proven cutaneous KS was undertaken to determine the clinical and histopathologic features, as well as any associations. METHODS: Two hundred and fifty cases of cutaneous KS in women from 1975 to 1993 were reviewed. RESULTS: Of the patients, 80% were more than 60 years of age, and of the patients less than 60 years old, 28 were from areas of the world with endemic KS. All HIV+ patients but one were from areas of endemic KS. Two patients were renal transplant patients. Sixty-four percent of the patients had single lesions and 21% recurrent lesions. Twelve patients had, or were known to develop, internal involvement, and in six patients the cause of death was KS. All but four cases histologically showed areas of solid proliferations of tumour cells consistent with plaque or tumour stage. An angiosarcoma-like histologic pattern appeared to be associated with more aggressive epidemiologic subsets. High mitotic rates were rarely seen and did not correlate with aggressive epidemiologic subsets. CONCLUSION: Kaposi's sarcoma in women is diagnosed almost exclusively in plaque or tumour stage. The majority of women within our study fit within the epidemiologic subset of sporadic KS.     

Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant

Kaposi sarcoma (KS) is a rare angioproliferative tumor whose etiology is associated with human herpesvirus 8 (HHV 8). KS lesions typically involve the skin or mucosal surfaces and are characterized by purplish, red-blue, or brown-black macules, papules, and nodules which are prone to bleeding and ulceration. Definitive diagnosis requires biopsy revealing characteristic angioproliferative features. There are four widely recognized types of KS, which are histologically indistinguishable but differ in epidemiology and prognosis. These include classic, endemic, iatrogenic, and epidemic. KS has been increasingly recognized in a new subgroup of patients: men who have sex with men (MSM) but who are HIV-seronegative human immuodeficiency virus-seronegative and have no identifiable immunodeficiency. This fifth variant of KS, termed nonepidemic KS, resembles classic KS in presentation and prognosis. In this literature review, we report the characteristics of nonepidemic KS based on all published cases and highlight the need for clinicians to recognize this new clinical variant.     

Kindler syndrome: a study of five Egyptian cases with evaluation of severity

Background Kindler syndrome (KS) is a rare genodermatosis characterized by four major features (acral blisters, photosensitivity, poikiloderma, and cutaneous atrophy) and many associated findings. The diagnosis of KS includes clinical features, ultrastructural findings, and, recently, immunostaining and genetic studies. Varying degrees of severity of the syndrome have been described. Methods Five patients with clinical features consistent with KS were included in this study. All patients were subjected to histopathologic and ultrastructural studies. Results Cases 1 and 2 presented with severe major features, severe mucosal involvement, and many other associated findings. Case 3 presented with severe major features, but mild and limited mucosal involvement and other associated findings. Cases 4 and 5 showed mild major features and few other findings. Histopathology revealed nonspecific poikiloderma. Marked thickening of the lamina densa and splitting of the lamina lucida were the main ultrastructural findings. Conclusion KS may be classified into mild, moderate, and severe according to the severity of the major features and mucosal involvement. Because histopathologic and ultrastructural findings are not pathognomonic, clinical features remain the mainstay for the diagnosis of KS, and the need for immunostaining with kindlin antibody and genetic studies may be restricted to early cases with incomplete features.     

Adult Kawasaki syndrome

Kawasaki syndrome (KS) is an idiopathic, acute, febrile, exanthemous illness that primarily affects infants and children. We describe a 20-year-old black woman who fulfilled the clinical criteria for the diagnosis of KS and excluded other possible causes. In addition, we reviewed data on 21 patients with adult KS reported in the English literature and accepted ten cases as representing this syndrome. The epidemiologic, clinical, laboratory, and pathologic features of the 11 cases representing adult KS are discussed. Although the initial reports of adult KS in the United States may have actually represented toxic shock syndrome, the occurrence of KS in adults should be acknowledged.     

艾滋病相关Kaposi肉瘤临床病理研究

目的认识皮肤Ｋａｐｏｓｉ肉瘤（ＫＳ）的临床病理表现及其与艾滋病的关系。方法用组织化学和免疫组织化学染色观察。结果研究了１０１例皮肤ＡＩＤＳ相关Ｋａｐｏｓｉ肉瘤，显示ＫＳ病变多见于下肢皮肤，常见于２０～４９岁男性患者，病理改变可分为斑、斑块及结节期。结论通过皮肤ＫＳ病变可以发现ＡＩＤＳ患者，免疫组化标记物第八因子相关抗原和波形蛋白有助于早期病变的诊断     

隆突性皮肤纤维肉瘤35例临床分析

目的:探讨隆突性皮肤纤维肉瘤(DFSP)的临床特点、超声表现、手术治疗以及病理诊断和鉴别诊断要点。方法:回顾性分析35例DFSP患者的临床表现、超声特点、组织病理学特点、治疗和预后。结果:35例患者中男性22例,女性13例;平均年龄(35.4±12.4)岁。临床典型表现为皮肤斑块、斑片或结节,未见溃疡。躯干最为多见。超声:肿物位于皮下,肿物边界清楚,边缘尚规则,内呈分叶状,瘤体内有低回声或混合性回声,其内可见稀疏或较丰富的血流信号。组织病理学特征为一致性梭形肿瘤细胞呈席纹状或车辐状排列,浸润性生长,部分区域肿瘤细胞异型性明显,似纤维肉瘤样改变,肿瘤细胞表达Vimentin。本组病例MMS手术者1例术后1年复发,2例术后3年复发。结论:DFSP形态多样,临床容易误诊,B超检查对诊断、判断肿物边界以及手术治疗有一定的指导意义,组织病理及免疫组化检查可进一步确诊。MMS对本病治疗有很大优势。     

Endemic Kaposi's sarcoma in human immunodeficiency virus type 1-seronegative persons: demonstration of retrovirus-like particles in cutaneous lesions

In 1984, Greek physicians reported on the clustering of cases of Kaposi's sarcoma (KS) on the Peloponnesus peninsula. To gain more insight into its pathogenesis, we studied the seroepidemiologic and clinicopathologic characteristics of 12 Greek KS patients (eight male/four female) five of whom were residents of an endemic area on the Peloponnesus. These patients were in good general health with ages ranging from 48 to 80 years, had no clinical signs of immunodeficiency, and combined the features of both classic and epidemic KS in that they displayed not only involvement of acral areas but also widespread mucocutaneous lesions. Routine laboratory data were within normal limits; no patient had HTLV-1 and HIV-1/2 antibodies, but all patients had antibodies to several herpesviruses. The histopathology was characteristic of KS with the peculiar feature of a dense infiltrate composed predominantly of CD4+ T lymphocytes. Immunoenzymatic/morphologic studies of the KS cells were consistent with their origin from lymphatic endothelium. Outstanding ultrastructural findings were tubuloreticular structures and cylindrical confronting cisternae, structures that are indicative of an ongoing viral infection. Indeed, extensive electronmicroscopic studies resulted in the detection of retrovirus-like particles in close association to KS cells in five of 12 patients. This in situ observation opens the possibility that this retro-virus contributes to KS development.     

Kaposi's sarcoma in renal transplant patients: experience at the Cruces Hospital in Bilbao

BACKGROUND: Kaposi's sarcoma (KS) in renal transplant recipients (RTRs) probably arises from a complex interplay of multiple factors. OBJECTIVE: In order to analyze the prevalence of KS in patients transplanted at the Cruces Hospital in Bilbao, together with their clinical features, treatment, and etiologic factors, we performed a study using the registry of RTRs in our center. METHODS: The records of 1,230 kidney transplant patients at the Cruces Hospital between 1979 and 1998 were reviewed. Immunosuppressive therapy was reduced once a diagnosis of KS was made. A nested polymerase chain reaction was used to detect human herpesvirus 8 (HHV-8) DNA in the biopsy tissue. The DNA was extracted from fresh tissue (n = 2) or from formalin-fixed, paraffin-embedded specimens (n = 5). RESULTS: Six cases of KS were diagnosed. All patients with cutaneous KS improved with a reduction in immunosuppressive drugs. HHV-8 was detected in 100% (2/2) of the frozen biopsies and 20% (1/5) of the formalin-fixed samples investigated. CONCLUSIONS: Our experience indicates that a continuous state of immunodeficiency is important for the development of KS in RTRs. The association, previously described between HHV-8 and transplant-associated KS, also exists in the studied population.     

Pyogenic granuloma-like Kaposi sarcoma: a diagnostic pitfall

Pyogenic granuloma-like Kaposi sarcoma (PG-like KS) is a clinicopathologic variant of Kaposi sarcoma (KS), a vascular tumor caused by human herpesvirus-8 (HHV-8). PG-like KS is a challenging entity to diagnose because its clinical and histological features encompass both pyogenic granuloma (PG) and KS characteristics. Immunhistochemical staining with HHV-8 latent nuclear antigen-1 (LNA-1) has been shown to exhibit high sensitivity and specificity for diagnosing KS. Therefore, the integration of clinical features and context, histopathogical findings, and immunohistochemical analysis is important in obtaining the correct diagnosis of PG-like KS. We report a case of PG-like KS in an HIV-positive man.