Kaposi Sarcoma Flashcards
Has what cell origin
Endothelial cell origin
linked w what type of infection?
HHV8
4 clinical variants
Classic KS, endemic African KS, immunosuppressive therapy-related KS,
HIV/AIDS-related KS.
systemic involvement
GI and lungs
African endemic type KS has what age prediliction and gender
young adults, mean age 35;
young children, mean age 3 years.
Males > females
what type of KS ,
Most common in solid transplant recipients as well as individuals treated chronically with immunosuppressive drugs. arises 16.5 months average after transplantation
Iatrogenic immunosuppression type
Risk of KS in HIV people compared w the general individual
Risk of KS 20,000 times that of the general population,
300 times that of other immunosuppressed individuals
Skin lesions.
most often starts as an ecchymotic-like macule
.Macules evolve into patches, papules, plaques, nodules, and tumors that
are violaceous, red, pink, or tan and become purple-brownish with a greening hemosiderin halo as they age. Often oval initially,and on the trunk enarranged parallel to skin tension lines . lesions may initially occur at sites of trauma, acral areas.
Distribution
almost always occur on the feet and legs or the hands, and slowly spread centripetally.
In HIV/AIDS-associated KS,there is early involvement to the face and widespread distribution on the trunk
Skin biopsy
Vascular channels lined by atypical endothelial cells among a network of reticulin fibers and extravasated erythrocytes with hemosiderin deposition.
In the nodular stage: Spindle cells in sheets and fascicles with mild- to-moderate cytologic atypia, single cell necrosis, trapped RBCs within an extensive network of slit like vascular spaces
Confirmation of dx is done by?
lesional skin biopsy
life span
CLASSIC KS Average survival,10to15years;
death usually from unrelated causes. Secondary malignancies arise in > 35% of cases.
AFRICAN-ENDEMIC KS Mean survival in young adults, 5 to 8 years; young children, 2 to
3 years.
tx
RADIOTHERAPY Indicated or tumorous lesions, conf uent lesions with a large sur ace area, large lesions on distal extremity, and large oropha- ryngeallesions.Cryosurgery.Indicated or deeply pigmented, protruding nodules. Laser Surgery. Pulsed-dye laser e ective or small super cial lesions. Photodynamic T erapy. For small super cial lesions.
ELECTROSURGERY E ective or ulcerated, bleeding nodular lesions. Excisional Surgery. E ective or selected small lesions. Intral- esional Cytotoxic Chemotherapy. Vinblastine, Vincristine,andBleomycin.
Aggressive Intervention
Single-Agent Chemotherapy. With adria- mycin, vinblastine, lipid ormulations o daunorubicin and doxorubicin. Paclitaxel
( axol), thalidomide, and col-3. Combination Chemotherapy. Vincristine + bleomycin + adriamycin or inter eron-α + zidovudine