Open AccessLYMPHANGIOMA-LIKE KAPOSI SARCOMA: CHALLENGES IN DIFFERENTIAL DIAGNOSIS
Author(s) -
Simona Roxana Georgescu,
Alexandra Maria Limbău,
Mircea Tampa,
Mihaela Tănăsescu,
Sabina Zurac,
Mircea Ioan Popa
Publication year - 2015
Publication title -
romanian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2069-606X
pISSN - 1220-5478
DOI - 10.37897/rmj.2015.4.11
Subject(s) - pathology , lymphangioma , sarcoma , medicine , differential diagnosis , angiosarcoma , immunohistochemistry , cd31 , cytokeratin , h&e stain , cd34 , lymphangiectasia , biology , lymphatic system , stem cell , genetics
Background. Kaposi’s sarcoma (KS) is a multifocal vascular neoplasia with uncertain histogenesis, characterized by angioproliferative multifocal tumors affecting mainly the skin. The “lymphangioma-like” or “bullous KS” variant is a rare morphologic expression of KS, accounting for less than 5% of all cases and appearing among all KS epidemiological subtype. This review provides a comprehensive overview of clinical and pathological characteristics of patients with lymphangioma-like Kaposi’s sarcoma LLKS. Methods. We included 93 patients with Kaposi sarcoma, aged between 36 and 90 years; diagnosis was made as a result of the histopathological examination. The surgical excision samples were fixed in 10% buffered formalin, paraffin embedded and stained with Hematoxylin-Eosin for histopathological examination. Immunohistochemical staining was performed using the following antibodies: CD34, CD31, actin, myoglobin, desmin, cytokeratin and vimentin. Results. The histological features of LLKS vary considerably from the traditional KS, classic KS areas have been absent from some lymphangioma-like KS. Most of the patients were diagnosed in nodular stage and confirmed by positive immunohistochemical staining. Clinically, each patient presented with violaceous patches, papules or plaques; some of the patients presented with bullous lesions. All tumour cells, including those associated with LLKS foci, showed a strong and diffuse reactivity for anti-HHV-8 LNA-1and anti-CD34. Conclusions. Differential diagnosis of lymphangioma-like Kaposi’s sarcoma LLKS with other vascular tumors may be very difficult and a detailed histologic study in combination with immunohistochemistry, such as staining for HHV-8 latent nuclear antigen, is essential for correctly diagnosing lymphangioma-like KS.