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Review
. 2017 Aug;18(4):529-539.
doi: 10.1007/s40257-017-0270-4.

Diagnosis and Treatment of Kaposi Sarcoma

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Free PMC article
Review

Diagnosis and Treatment of Kaposi Sarcoma

Johann W Schneider et al. Am J Clin Dermatol. .
Free PMC article

Abstract

Kaposi sarcoma (KS) is the most common neoplasm of people living with HIV today. In Sub-Saharan Africa, KS is among the most common cancers in men, overall. Not only HIV-positive individuals present with KS; any immune compromised person infected with KS-associated herpesvirus (KSHV) or human herpesvirus 8 is at risk: the elderly, children in KSHV-endemic areas, and transplant recipients. KS diagnosis is based on detection of the viral protein latency-associated nuclear antigen (LANA) in the biopsy, but not all cases of KS are the same or will respond to the same therapy. Standard KS therapy has not changed in 20 years, but newer modalities are on the horizon and will be discussed.

Figures

Figure 1
Figure 1. KS pathology and histology
Panel A shows an image of gross morphology of disseminated KS on the surface of the lung. Note the single, raised, nodular lesion in the upper left, as compared to the flat lesions. Panel B shows a computer-enhanced image of immunofluorescence in a KSHV recombinant virus that also expressed green fluorescent protein (gfp) in a PEL cell line. LANA staining is in red, nuclear DNA staining in blue and gfp (to indicate infected cells) in green. This analysis clearly shows the presence of discrete “LANA dots”, each indicating a place where the viral genome is tethered to the host chromosome. Panel C shows an image of LANA staining of a KS lesion by immunohistochemistry (brown) with hematoxilin counterstain (blue). Note all LANA staining is nuclear and the appearance of darker spots or dots within the nuclear staining. Panel D, shows an H&E stain of a KS lesion. Note the spindle shape nature of the cells, which are of endothelial cell lineage. Slit-like spaces in between the cells contain extravasated red blood cells.
Figure 2
Figure 2. Review of KS incidence rates based on US SEER data (10-15-2016)
Data and graphs were obtained using the SEER data website (http://seer.cancer.gov/explorer/). For panels A–B the calendar year is shown on the horizontal and incidence rate per 100,000 on the vertical axis. Panel A stratifies data by age (orange circle: <65 and gray triangle: >65+). Panel B stratifies data by race/ethnicity (red circle: African American and White: blue triangle). Panel C shows 5-year survival by calendar interval and also stratifies data by race/ethnicity (red circle: African American and White: blue triangle).

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