Kaposi’s sarcoma - HIV

Kaposi’s sarcoma

Definition

A multi-focal disease caused malignant by proliferation of vascular endothelial cells.

Aetiology/pathophysiology

Kaposi’s sarcoma in AIDS patients is particularly common in sexually transmitted HIV suggesting a sexually transmitted cofactor such as human herpes virus 8. Ka-posi’s sarcoma affects the skin, lung, lymphatic system and gastrointestinal system.

Clinical features

Skin lesions occur most commonly on the lower limbs and appear in various colours from pale pink, through violet to dark brown due to their vascularity. They may appear as plaques especially on the soles of the feet or dome shaped firm papules, which may ulcerate. Gas-trointestinal Kaposi’s sarcoma is usually asymptomatic but may cause perforation, obstruction, haemorrhage, jaundice from biliary obstruction, or protein losing enteropathy due to mesenteric lymphatic obstruction. Dissemination to the lungs and brain may occur.

Investigations

A clinical diagnosis, however biopsy reveals endothelial lined spaces interspersed by proliferating spindle cells.

Management

Localised or cutaneous lesions may respond to radiotherapy. Dissemination or visceral lesions require systemic chemotherapy.

Prognosis

Cutaneous Kaposi’s sarcoma may be non-aggressive, however visceral and disseminated disease can be serious and life threatening.