Oral and maxillofacial pathology| Volume 115, ISSUE 2, P241-248, February 2013

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Microscopic diversity in oral Kaposi sarcoma

      Kaposi sarcoma is the most common HIV-associated neoplasm, frequently presenting with oral mucosal involvement. This retrospective study aimed to assess and highlight the histomorphological spectrum of oral Kaposi sarcoma. A total of 135 cases diagnosed between 1990 and 2011 were retrieved from the archives of the Oral and Dental Hospital of the University of Pretoria, South Africa. Following histologic review, each case was placed into 1 of 7 categories based on the predominant pattern of growth. These histologic divisions included lesions designated as solid, lymphangioma-like, telangiectatic, desmoplastic, lymphangiectatic, ecchymotic, and anaplastic. The presence of coexistent pathology was identified in 25 cases, largely represented by superimposed candidiasis. Concomitant cytomegalovirus and non-necrotizing granulomatous inflammation were also observed. Although the prognostic significance of these variants is yet to be determined, the appreciation and recognition of such morphologic diversity remains essential in distinguishing these lesions from possible mimickers.
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        • Knuutila S.
        • Lamovec J.
        Kaposi sarcoma.
        in: Fletcher C.D.M. Mertens F. Pathology and genetics of tumours of soft tissue and bone. IARC Press, Lyon, France2002 (UK)
        • Newland J.R.
        • Lynch D.P.
        • Ordonez N.G.
        Intraoral Kaposi's sarcoma: a correlated light microscopic, ultrastructural, and immunohistochemical study.
        Oral Surg Oral Med Oral Pathol. 1988; 66: 48-58
        • Schwartz R.A.
        Kaposi's sarcoma: an update.
        J Surg Oncol. 2004; 87: 146-151
        • Kaposi M.
        Idiopathisches multiples Pigmentsarkom der haut.
        Arch Dermatol Syph (Prague). 1872; 4: 265-273
        • Papagatsia Z.
        • Jones J.
        • Morgan P.
        • Tappuni A.R.
        Oral Kaposi sarcoma: a case of immune reconstitution inflammatory syndrome.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108: 70-75
        • Fatahzadeh M.
        Kaposi's sarcoma: review and medical management update.
        Oral Surg Oral Med Oral Pathol. 2012; 113: 2-16
        • Schwartz R.A.
        • Micali G.
        • Nasca M.R.
        • Scuderi L.
        Kaposi sarcoma: a continuing conundrum.
        J Am Acad Dermatol. 2008; 59 (quiz 7-8): 179-206
        • Martellotta F.
        • Berretta M.
        • Vaccher E.
        • Schioppa O.
        • Zanet E.
        • Tirelli U.
        AIDS-related Kaposi's sarcoma: state of the art and therapeutic strategies.
        Curr HIV Res. 2009; 7: 634-638
        • Chang Y.
        • Cesarman E.
        • Pessin M.S.
        • Lee F.
        • Culpepper J.
        • Knowles D.M.
        • Moore P.S.
        Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma.
        Science. 1994; 266: 1865-1869
        • Anonymous
        Global report: UNAIDS report on the global AIDS epidemic 2010.
        (Accessed June 15, 2012)
        • Lager I.
        • Altini M.
        • Coleman H.
        • Ali H.
        Oral Kaposi's sarcoma: a clinicopathologic study from South Africa.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 701-710
        • Rohrmus B.
        • Thoma-Greber E.M.
        • Bogner J.R.
        • Röcken M.
        Outlook in oral and cutaneous Kaposi's sarcoma.
        Lancet. 2000; 356: 2160
        • Epstein J.B.
        • Scully C.
        HIV infection: clinical features and treatment of thirty-three homosexual men with Kaposi's sarcoma.
        Oral Surg Oral Med Oral Pathol. 1991; 71: 38-41
        • Epstein J.B.
        • Cabay R.J.
        • Glick M.
        Oral malignancies in HIV disease: changes in disease presentation, increasing understanding of molecular pathogenesis, and current management.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100: 571-578
        • Bottler T.
        • Kuttenberger J.
        • Hardt N.
        • Oehen H.P.
        • Baltensperger M.
        Non-HIV-associated Kaposi's sarcoma of the tongue.
        Int J Oral Maxillofac Surg. 2007; 36: 1218-1220
        • Vanni T.
        • Sprinz E.
        • Machado M.W.
        • Santana Rde C.
        • Fonseca B.A.
        • Schwartsmann G.
        Systemic treatment of AIDS-related Kaposi sarcoma: current status and perspectives.
        Cancer Treat Rev. 2006; 32: 445-455
        • Bower M.
        • Nelson M.
        • Young A.M.
        • Thirlwell C.
        • Newsom-Davis T.
        • Mandalia S.
        • et al.
        Immune reconstitution inflammatory syndrome associated with Kaposi's sarcoma.
        J Clin Oncol. 2005; 23: 5224-5228
        • Regezi J.A.
        • MacPhail L.A.
        • Daniels T.E.
        • Greenspan J.S.
        • Greenspan D.
        • Dodd C.L.
        • et al.
        Oral Kaposi's sarcoma: a 10-year retrospective histopathologic study.
        J Oral Pathol Med. 1993; 22: 292-297
        • Reichart P.A.
        • Schiødt M.
        Non-pigmented oral Kaposi's sarcoma (AIDS).
        Int J Oral Maxillofac Surg. 1989; 18: 197-199
        • Pantanowitz L.
        • Moses A.V.
        • Dezube B.J.
        The inflammatory component of Kaposi sarcoma.
        Exp Mol Pathol. 2009; 87: 163-165
        • Lumerman H.
        • Freedman P.D.
        • Kerpel S.M.
        • Phelan J.A.
        Oral Kaposi's sarcoma: a clinicopathologic study of 23 homosexual and bisexual men from the New York metropolitan area.
        Oral Surg Oral Med Oral Pathol. 1988; 65: 711-716
        • Pantanowitz L.
        • Grayson W.
        • Simonart T.
        • Dezube B.J.
        Pathology of Kaposi's sarcoma.
        J HIV Ther. 2009; 14: 41-47
        • Eng W.
        • Cockerell C.J.
        Histological features of Kaposi sarcoma in a patient receiving highly active antiviral therapy.
        Am J Dermatopathol. 2004; 26: 127-132
        • Grayson W.
        • Pantanowitz L.
        Histological variants of cutaneous Kaposi sarcoma.
        Diagn Pathol. 2008; 3: 31
        • Pantanowitz L.
        • Dezube B.J.
        • Pinkus G.S.
        • Tahan S.R.
        Histological characterization of regression in acquired immunodeficiency syndrome-related Kaposi's sarcoma.
        J Cutan Pathol. 2004; 31: 26-34
        • Chaudhary M.
        • Gadbail A.R.
        • Vidhale G.
        • Mankar Gadbail M.P.
        • Gondivkar S.M.
        • Gawande M.
        • Patil S.
        Comparison of myofibroblasts expression in oral squamous cell carcinoma, verrucous carcinoma, high risk epithelial dysplasia, low risk epithelial dysplasia and normal oral mucosa.
        Head Neck Pathol. 2012; 6: 305-313
        • Räsänen K.
        • Vaheri A.
        Activation of fibroblasts in cancer stroma.
        Exp Cell Res. 2010; 316: 2713-2722
        • Pietras T.A.
        • Baum C.L.
        • Swick B.L.
        Coexistent Kaposi sarcoma, cryptococcosis, and Mycobacterium avium intracellulare in a solitary cutaneous nodule in a patient with AIDS: report of a case and literature review.
        J Am Acad Dermatol. 2010; 62: 676-680
        • Grayson W.
        Recognition of dual or multiple pathology in skin biopsies from patients with HIV/AIDS.
        Patholog RES Int. 2011; 2011: 398546
        • Ramdial P.K.
        • Sing Y.
        • Subrayan S.
        • Calonje E.
        Cutaneous colesional acquired immunodeficiency syndrome associated Kaposi sarcoma and cryptococcosis.
        Am J Dermatopathol. 2010; 32: 780-786
        • Pontes H.A.
        • Guimarães D.M.
        • Pontes F.S.
        • Paiva H.B.
        • Pinto L.C.
        • de Freitas Silva B.S.
        • Dos Santos Pinto D.
        Kaposi sarcoma and paracoccidioidomycosis in the same fragment of oral mucosa biopsy: a rare association in a human immunodeficiency virus-positive patient.
        Diagn Microbiol Infect Dis. 2011; 69: 196-199
        • Kandemir N.O.
        • Yurdakan G.
        • Bektas S.
        • Tekin N.S.
        Classic Kaposi sarcoma with sarcoid-like granulomas: a case report and literature review.
        Exp Mol Pathol. 2009; 87: 89-93
        • Glassman S.J.
        • Hale M.J.
        Cutaneous cryptococcosis and Kaposi's sarcoma occurring in the same lesions in a patient with the acquired immunodeficiency syndrome.
        Clin Exp Dermatol. 1995; 20: 480-486