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  • Title: Clinical and histopathological aspects of Kaposi's sarcoma in Africa: relationship with HIV serology.
    Author: Lesbordes JL, Martin PM, Ravisse P, Georges-Courbot MC, Georges AJ.
    Journal: Ann Inst Pasteur Virol; 1988; 139(2):197-203. PubMed ID: 2905140.
    Abstract:
    From 1983 to 1987, 45 Kaposi's sarcomas (KS) were diagnosed at the University Hospital in Bangui; 37 cases were easily classified as either endemic or AIDS-related KS on clinical grounds and HIV serology. Moreover, probably due to the stage at which patients consulted and lesions were sampled, noticeable histopathological differences were observed between the two clinical presentations. But for 8/45 which we classified as "borderline KS", strong discrepancies occurred between clinical aspects, patient evolution, HIV serology and histopathology. In two cases, HIV-positive patients had typical endemic non-evolutive KS and have survived 15 and 36 months. 45 cases of Kaposi's sarcoma diagnosed in Bangui, Central African Republic since 1983 were compared with respect to clinical features, evolution, HIV seroprevalence, immune status and histopathology. 37 cases were categorized as typical endemic KS or atypical aggressive KS, but 8 were found to be "borderline KS" with mixed characteristics. Endemic KS presents as a simple hemangioma with granulations in clusters of capillaries, both in the epidermis and dermis. Later 3 types of tissue damage may be seen: 1) nodular mixed fibroblasts, spindle cells, lymphocytes and histiocytes with vascular slits; 2) fibrocystoma-like; 3) angiosarcoma-like. AIDS-related KS showed scattered spindle cells, vascular slits resembling capillaries, considerable infiltration by plasma cells, lymphocytes and inflammatory cells, PAS-positive eosinophilic tumor cells, and ferric pigmented macrophages. Typical endemic KS lesions are multifocal and limited to the lower extremities. Aggressive AIDS-related KS lesions were infiltrative, edematous or indurated, sometimes located buccally or conjunctively. All 45 patients could be classified as endemic or aggressive KS clinically. None of the patients with clearly endemic KS had antibodies to HIV. The 8 borderline cases had a wide variation in findings. The mean survival times for 6 endemic KS patients was 30 months or more; that of the AIDS-related KS patients was 3.5 months.
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