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Thread: Kaposi Sarcoma Pictures - Atlas of Colon and Ileum

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    Default Kaposi Sarcoma Pictures - Atlas of Colon and Ileum

    Summary
    Kaposi's sarcoma is a cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat or in other organs. The patches are usually red or purple and are made of cancer cells and blood cells. The red and purple patches often cause no symptoms, though they may be painful. If the cancer spreads to the digestive tract or lungs, bleeding can result. Lung tumors can make breathing hard.

    Before the HIV/AIDS epidemic, KS usually developed slowly. In HIV/AIDS patients, though, the disease moves quickly. Treatment depends on where the lesions are and how bad they are. Treatment for HIV itself can shrink the lesions. However, treating KS does not improve survival from HIV/AIDS itself.

    Signs and symptoms
    KS lesions are nodules or blotches that may be red, purple, brown, or black, and are usually papular (in other words, palpable or raised).

    They are typically found on the skin, but spread elsewhere is common, especially the mouth, gastrointestinal tract and respiratory tract. Growth can range from very slow to explosively fast, and is associated with significant mortality and morbidity.

    Skin
    Commonly affected areas include the lower limbs, back, face, mouth, and genitalia. The lesions are usually as described above, but may occasionally be plaque-like (often on the soles of the feet) or even involved in skin breakdown with resulting fungating lesions. Associated swelling may be from either local inflammation or lymphoedema (obstruction of local lymphatic vessels by the lesion). Skin lesions may be quite disfiguring for the sufferer, and a cause of much psychosocial pathology.
    Kaposi Sarcoma Pictures Atlas Colon attachment.php?s=60116a9f3fd2bc88ff52ce6e08ffcdfd&attachmentid=2065&d=1442182944

    Mouth
    The mouth is involved in about 30% of cases, and is the initial site in 15% of AIDS-related KS. In the mouth, the hard palate is most frequently affected, followed by the gums. Lesions in the mouth may be easily damaged by chewing and bleed or suffer secondary infection, and even interfere with eating or speaking.

    Gastrointestinal tract
    Involvement can be common in those with transplant-related or AIDS-related KS, and it may occur in the absence of skin involvement. The gastrointestinal lesions may be silent or cause weight loss, pain, nausea/vomiting, diarrhea, bleeding (either vomiting blood or passing it with bowel motions), malabsorption, or intestinal obstruction.

    Respiratory tract
    Involvement of the airway can present with shortness of breath, fever, cough, hemoptysis (coughing up blood), or chest pain, or as an incidental finding on chest x-ray.The diagnosis is usually confirmed by bronchoscopy when the lesions are directly seen, and often biopsied.

    Transmission
    In Europe and North America, KSHV is transmitted through saliva. Thus, kissing is a theoretical risk factor for transmission. Higher rates of transmission among gay and bisexual men have been attributed to "deep kissing" sexual partners with KSHV. Another alternative theory suggests that use of saliva as a sexual lubricant might be a major mode for transmission. Prudent advice is to use commercial lubricants when needed and avoid deep kissing with partners with KSHV infection or whose status is unknown.

    KSHV is also transmissible via organ transplantation and blood transfusion.Testing for the virus before these procedures is likely to effectively limit iatrogenic transmission.
    Kaposi Sarcoma Pictures Atlas Colon attachment.php?s=60116a9f3fd2bc88ff52ce6e08ffcdfd&attachmentid=2066&d=1442182957

    Pathology and diagnosis
    Despite its name, in general it is not considered a true sarcoma,[28][29] which is a tumor arising from mesenchymal tissue. The histogenesis of KS remains controversial. According to some, KS arises as a cancer of lymphatic endothelium[citation needed] and forms vascular channels that fill with blood cells, giving the tumor its characteristic bruise-like appearance. KSHV proteins are uniformly detected in KS cancer cells.

    KS lesions contain tumor cells with a characteristic abnormal elongated shape, called spindle cells. The most typical feature of Kaposi sarcoma is the presence of spindle cells forming slits containing red blood cells. Mitotic activity is only moderate and pleomorphism is usually absent. The tumor is highly vascular, containing abnormally dense and irregular blood vessels, which leak red blood cells into the surrounding tissue and give the tumor its dark color. Inflammation around the tumor may produce swelling and pain. Variously sized PAS positive hyaline bodies are often seen in the cytoplasm or sometimes extracellularly.

    The spindle cells of Kaposi sarcoma differentiate toward endothelial cells, probably of lymph vessel rather than blood vessel nature.The consistent immunoreactivity for podoplanin supports the lymphatic nature of the lesion.

    HHV8 is present in almost 100% of Kaposi sarcoma lesions, whether HIV-related, classic, endemic, or iatrogenic.

    Although KS may be suspected from the appearance of lesions and the patient's risk factors, definite diagnosis can be made only by biopsy and microscopic examination. Detection of the KSHV protein LANA in tumor cells confirms the diagnosis.
    Kaposi Sarcoma Pictures Atlas Colon attachment.php?s=60116a9f3fd2bc88ff52ce6e08ffcdfd&attachmentid=2067&d=1442182970

    In differential diagnosis, arteriovenous malformations, pyogenic granuloma and other vascular proliferations can be microscopically confused with KS.

    Prevention
    Blood tests to detect antibodies against KSHV have been developed and can be used to determine whether a person is at risk for transmitting infection to their sexual partner, or whether an organ is infected prior to transplantation. However, these tests are not available except as research tools, and, thus, there is little screening for persons at risk for becoming infected with KSHV, such as people following a transplant.

    Treatment
    Kaposi sarcoma is not curable (in the usual sense of the word), but it can often be treatable for many years. In KS associated with immunodeficiency or immunosuppression, treating the cause of the immune system dysfunction can slow or stop the progression of KS. In 40% or more of peoples with AIDS-associated Kaposi sarcoma, the Kaposi lesions will shrink upon first starting highly active antiretroviral therapy (HAART). However, in a certain percentage of such people, Kaposi sarcoma may again grow after a number of years on HAART, especially if HIV is not completely suppressed.

    People with a few local lesions can often be treated with local measures such as radiation therapy or cryosurgery Weak evidence suggests that antiretroviral therapy in combination with chemotherapy is more effective than either of those two therapies individually. In general, surgery is not recommended, as Kaposi sarcoma can appear in wound edges. In general, more widespread disease, or disease affecting internal organs, is treated with systemic therapy with interferon alpha, liposomal anthracyclines (such as Doxil) or paclitaxel.
    Kaposi Sarcoma Pictures Atlas Colon attachment.php?s=60116a9f3fd2bc88ff52ce6e08ffcdfd&attachmentid=2068&d=1442182984

    Reactivation
    KSHV was been shown to become reactivate from latency by IL-4 in vitro., which may be produced during infection, in a laboratory test in mice infected with helminths, the related virus reactivated due to immune signal IL-4 in vivo.

    Epidemiology
    With the decrease in the death rate among people with HIV/AIDS receiving new treatments in the 1990s, the rates and severity of epidemic KS also decreased. However, the number of people living with HIV/AIDS is increasing in the United States, and it is possible that the number of people with AIDS-associated Kaposi sarcoma will again rise as these people live longer with HIV infection.

    Awareness
    It has been reported that only 6% of men who have sex with men are aware that KS is caused by a virus different from HIV. Thus, there is little community effort to prevent KSHV infection. Likewise, no systematic screening of organ donations is in place.

    In people with AIDS, Kaposi sarcoma is considered an opportunistic infection, a disease that is able to gain a foothold in the body because the immune system has been weakened. With the rise of HIV/AIDS in Africa, where KSHV is widespread, KS has become the most frequently reported cancer in some countries.

    Because of their highly visible nature, external lesions are sometimes the presenting symptom of AIDS. Kaposi sarcoma entered the awareness of the general public with the release of the film Philadelphia, in which the main character was fired after his employers found out he was HIV-positive due to visible lesions. By the time KS lesions appear, it is likely that the immune system has already been severely weakened.

    References:
    Kaposi's Sarcoma: MedlinePlus
    https://en.wikipedia.org/wiki/Kaposi's_sarcoma











    Last edited by Medical Photos; 09-13-2015 at 10:23 PM.

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