卡波西肉瘤一例

正临床资料患者,男,22岁,福建人。主因双下肢皮疹渐增多1年余,于2014年7月11日就诊。1年余前,无明显诱因患者双下肢屈侧出现散在黄豆大黑褐色丘疹,无明显痒痛,未诊治。后皮损逐渐增多增大变硬,偶感疼痛,曾就诊外院按"湿疹、瘢痕疙瘩"予外用药物等治疗,皮损无明显好转。既往乙型病毒性肝炎及乙型肝炎相关性肾炎病史5年余,2012年     

Intravascular and diffuse dermal reactive angioendotheliomatosis secondary to iatrogenic arteriovenous fistulas

Reactive angioendotheliomatosis is a rare benign process that has been mainly described in patients with systemic infections, such as subacute bacterial endocarditis or tuberculosis, and in association with intravascular deposition of cryoproteins. Histopathologically, it is characterized by a proliferation of endothelial cells within vascular lumina resulting in the obliteration of the involved vessels. Another rare variant of reactive angioendotheliomatosis has been described in the lower extremities of patients with severe peripheral vascular atherosclerotic disease. It consists of violaceous and purpuric plaques histopathologically characterized by diffuse proliferation of endothelial cells interstitially arranged between collagen bundles of the reticular dermis. This second variant has been named diffuse dermal reactive angioendotheliomatosis. We report two patients with reactive cutaneous angioendotheliomatosis appearing distally to arteriovenous fistulas used for hemodialysis because of chronic renal failure. The first patient showed intravascular reactive angioendotheliomatosis, while the second one had purpuric plaques that were characterized histopathologically by diffuse dermal angioendotheliomatosis. Both patients showed an arteriovenous "steal" syndrome with distal ischemia, and it is possible that a local increase of vascular endothelial growth factor, as is the case in hypoxia situations, induces the endothelial proliferation. To the best of our knowledge, cutaneous reactive angioendotheliomatosis has not been previously described in association with arteriovenous shunts.     

艾滋病相关型卡波西肉瘤1例

报告以左手背暗红色半球状结节为表现的艾滋病相关型卡波西（Kaposi）肉瘤1例。患者男,31岁。发热、双侧耳后肿痛18天,入院前10天左手背出现暗红色圆形结节,渐增大为2个半球状结节。抗HIV抗体（＋）。皮肤组织病理检查示：Kaposi’s肉瘤。诊断：艾滋病相关型卡波西肉瘤。拉米夫定（3TC）、司他夫定（D4T）、克力芝（洛匹那韦／利托那韦）抗病毒治疗3个月后,皮损逐渐消退。     

经典型Kaposi肉瘤1例

Kaposi肉瘤在我国主要散发于新疆少数民族地区,内地报道较少。我科近期诊治1例,现报告如下。临床资料患者,男,75岁。主因双足背、足跖深褐色皮疹18年加重2年就诊。患者18年前右足跖内侧缘出现1cm大小的深褐色皮疹,无明显自觉症状。于当地就诊,未明确诊断,建议冷冻治疗,患者拒绝。     

Chemotherapy of disseminated cutaneous classic Kaposi's sarcoma with vinblastine

Classic Kaposi's Sarcoma (KS) is a rare indolent cutaneous malign proliferative disease affecting predominantly elderly men of Mediterranean and Jewish origin. Classic KS generally does not require treatment for a prolonged time. Systemic therapy is indicated for patients with advanced disease. We present here a 78-year-old woman with disseminated cutaneous classic KS who was successfully treated with single agent vinblastine. Vinblastine is very effective, less toxic and less costly in the treatment of elderly patients with disseminated classic KS.     

经典型Kaposi肉瘤1例

经典型Ｋａｐｏｓｉ肉瘤（ＣＫＳ）在我国汉族人中罕见,我们对１例汉族ＣＫＳ患者进行血清多种病毒抗体和性激素水平,细胞和体液免疫功能、电子显微镜和免疫组织化学等检查,以期了解ＣＫＳ的病因和发病机理。     

Classic Kaposi's sarcoma: a case report

A 60-year-old male from the Mediterranean area presented with edematous right leg and livid nodules and macules on the skin of upper and lower extremities. Biopsy specimen obtained from the right upper leg showed a pathohistologic finding indicative of Kaposi's sarcoma. Polymerase chain reaction testing revealed HHV-8 in the skin lesion. Serology for HIV was negative. Additional examinations did not reveal dissemination of the disease. Negative HIV serology, normal laboratory findings and absence of immunosuppressant therapy in the patient's history confirmed the diagnosis of the classic form of Kaposi's sarcoma.     

Scanning electron microscopic features of Kaposi's sarcoma

In order to clarify the three-dimensional structure of Kaposi's sarcoma (KS) five cases of KS of the skin were observed with a scanning electron microscope (SEM). KS lesions were investigated both in vascular and spindle cell areas and were compared with similar areas observed by light microscopy. KS appears as a spongelike neoplasm consisting of irregular vascular channels lacking endothelial cells and well-developed basement membranes. Vascular spaces and vascular slits are packed with numerous red blood cells (RBCs). SEM features of KS share some similarities with those of hemangiopericytoma, a vascular tumor composed of mature endothelial cells surrounded by pericytes. These findings are consistent with the hypothesis according to which the proliferating cells of KS are viewed as immature endothelial cells with partial differentiation into pericytes.     

A case of Kaposi's sarcoma associated with pemphigoid nodularis

Pemphigoid nodularis is a rare variant of bullous pemphigoid. Bullous pemphigoid complicated by internal malignancy has been well documented. There have been only a few reported cases of bullous pemphigoid associated with Kaposi's sarcoma. We described a case of pemphigoid nodularis who later developed Kaposi's sarcoma that might be related to immunosupressive therapy, a situation that has not been reported previously.     

A case of immunodependent Kaposi's sarcoma against a background of glucocorticoid treatment

A patient with bullous pemphigoid has developed immunodependent Kaposi's sarcoma during immunosuppressant therapy. It may be supposed that the initial manifestations of Kaposi's sarcoma developed in the gastrointestinal tract, inducing the development of bullous pemphigoid in the presence of massive immunosuppressant therapy.     

AIDS-associated Kaposi's sarcoma in a heterosexual male--a case report

A 39 year old married heterosexual male presented with extensive purpuric macules, papules, and lichenoid plaques scattered over his skin and mucocutaneous surfaces for one year. The lesions were larger in both his groins, and were associated with lymphedema of his penis and scrotum. His serology for the HIV-1 virus was positive. Biopsies from multiple lesions confirmed the diagnosis of Kaposi's sarcoma. Histochemistry was positive for the HHV-8 virus. He subsequently developed pulmonary and peritoneal effusions and died 3 months later of cardiopulmonary arrest.     

A case of classic Kaposi's sarcoma with multiple organ involvement

Kaposi's sarcoma is a systemic, multifocal, angiomatous tumor which can be classified into four clinical variants. Among them, classic Kaposi's sarcoma is rare in Oriental people, and the involvement of internal organs in this variant is reported to be very rare. We present a case of classic Kaposi's sarcoma in a 67-year-old Korean male, who had multiple organ involvement in the skin, lymph node, and stomach. Lesions of Kaposi's sarcoma cleared after treatment with etoposide, but the skin lesions recurred after a three-month symptom-free period. He was treated with doxorubicin, bleomycin, and vincristine, and all the skin lesions were cleared.     

Micronodular Kaposi's sarcoma - a new variant of classic-sporadic Kaposi's sarcoma

Kaposi's sarcoma (KS) in its classic-sporadic form is a rare vascular neoplasm affecting predominantly elderly men of Jewish or Mediterranean origin. Women are very rarely affected by KS. The tumor manifests itself most commonly with brownish macular or infiltrated oval lesions on the lower legs in both genders. Human herpesvirus 8 (HHV-8) has recently been demonstrated to be etiologically linked to KS. We report a 51-year-old HIV-seronegative Caucasian woman with an unusual, previously not described variant of KS which presented with small (3 mm in diameter) scattered firm red papules on her right arm. The histology with nodular spindle cell tumor expressing endothelial markers, the demonstration of serum antibodies against HHV-8 and the presence of viral nucleic acids in the lesional tissue proved the diagnosis of the nodular stage of KS. An indolent course characterized by clinically identical seasonal recurrences, even after surgical treatment and cryosurgery, was observed during the follow-up period of 9 years. We propose the term 'micronodular KS' for this unusual clinical variant of KS mimicking capillary hemangioma.     

Classic dissemination of Kaposi's sarcoma: report of a case

An 86-year-old male presented with a disseminated dermatosis characterized by erythematous and violaceous papules and nodules of 0.5-1.0 cm in diameter. The upper and lower limbs were affected and lower limb edema was promiment. Upon histological examination the diagnosis of classic Kaposi's Sarcoma was confirmed. There is still controversy if Kaposi's Sarcoma is a true neoplasm, a proliferative reaction, or both.