Kaposi's Sarcoma: clinical and pathological aspects in patients seen at the Hospital Universitário Cassiano Antônio Moraes - Vitória - Espírito Santo - Brazil / Sarcoma de Kaposi: achados clínico-patológicos nos pacientes atendidos no Hospital Universitário Cassiano Antônio Moraes - Vitória - Espírito Santo - Brazil

BACKGROUND: Kaposi's sarcoma is a neoplasm of endothelial origin that is divided into four distinct types according to the clinical characteristics and the affected population: Classic (in elder men of Jewish or Mediterranean origin); Epidemic (in patients affected by AIDS); Endemic (in black African men) and Iatrogenic (in patients under immunosuppressive regimens). Human herpesvirus 8 infection is essential but not sufficient for the sarcoma development. OBJECTIVE: To describe the epidemiological, clinical and histopathological aspects of patients with KS seen at the Dermatology Clinic -Cassiano Antônio Moraes University Hospital - Federal University of Espirito Santo, Vitória - ES. METHODS: A descriptive and retrospective study based on clinical charts of patients with KS seen at the Dermatology Clinic from 1986 to 2009. RESULTS: The majority of the 15 cases were male patients (93,3%) and white (60%). Epidemic Kaposi's sarcoma occurred in 80%, and the Classic form in 20%, with no cases in the Endemic or Iatrogenic groups. All the histopatho logical exams of the cutaneous lesions were reviewed and a proliferation of fusiform cells, extravasated erythrocytes and vascular rifts among the largest vessels, assuming the "vessels in vessels" typical aspect, were seen. CONCLUSION: The number of cases of Kaposi's Sarcoma was linear throughout the years of the study, especially of the epidemic form, although the incidence and prevalence of AIDS increased in the state of Espírito Santo. Therefore, if we consider the relation between KS and AIDS, a decreasing line of Kaposi's sarcoma could be seen, especially after the introduction of HAART.

FUNDAMENTOS: O Sarcoma de Kaposi é neoplasia de origem endotelial, dividida em quatro formas clínicas: clássica (homens idosos de origem judaica e mediterrânea), epidêmica (associada ao HIV), endêmica (negros africanos) e iatrogênica (relacionada à imunossupressão). A infecção pelo herpes vírus humano tipo 8 (HHV-8) é necessária, mas insuficiente para que todas as formas possam ocorrer. OBJETIVOS: Avaliar os aspectos epidemiológicos, clínicos e características histopatológicas das lesões dos pacientes com Sarcoma de Kaposi consultados no Serviço de Dermatologia do Hospital Universitário Cassiano Antônio Moraes - Universidade Federal do Espírito Santo, Vitória - ES. MÉTODOS: Estudo retrospectivo, descritivo, realizado pela análise dos prontuários dos pacientes diagnosticados com Sarcoma de Kaposi, durante janeiro de 1986 a dezembro de 2009, no Serviço de Dermatologia. RESULTADOS: Dos 15 pacientes estudados, houve maioria do sexo masculino (93,3%) e predomínio da raça branca (60%). A forma epidêmica foi a mais freqüente (80%), seguida pela clássica (20%). Não foram observadas as formas: endêmica e iatrogênica. A revisão das lâminas das biópsias cutâneas foi feita nos 15 casos, e demonstrou derme com proliferação de células fusiformes, extravasamento de hemácias e fendas vasculares em torno de vasos maiores, com aspecto clássico de "vasos em torno de vasos". CONCLUSÕES: O número de casos de Sarcoma de Kaposi foi linear ao longo do estudo, especialmente da forma epidêmica. Por outro lado, a incidência e a prevalência da AIDS no Espírito Santo foram crescentes. Portanto, considerando-se a relação entre o sarcoma de Kaposi e a AIDS houve decréscimo do primeiro, mais acentuado após a era HAART.

Prevalence of koposi's sarcoma in north of Iraq after the second gulf war 1991

Is to show the marked increase in the incidence of Kaposi's sarcoma specially atypical fulminating forms in the north provinces of Iraq after the Second Gulf War 1991. A retrospective comparative study of 404 patients with the diagnosis of Kaposi's sarcoma [372 men and 32 women], their ages ranged between 54 and 75 years, admitted to the surgical and dermatological departments in north provinces from June 1994 till September 2004. The clinical presentation of the patients, hematological and serological investigations, imaging and radiological studies were considered in all the cases. Final diagnosis was established by hitopathological examinations. Patients with the diagnosis of Kaposi's sarcoma were divided into 3 main groups according to the clinical and pathological behavior of the disease: Group I, [276 patients, 68.3%] with typical classical type of Kaposi's sarcoma, and group II [116 patients, 28.7%] with atypical fulminating types [lymph-adenopathic; African], and group III [12patients, 1.9%] with immunosuppresion associated [transplant] form of disease were studied. The diagnosis was confirmed by histological examinations of the skin, oral lesions, bronchial and visceral lesions. 44 patients underwent explorative laparotomies and diagnostic laparoscopy because of the dominancy of the abdominal symptoms and signs, 40 of them required more than one surgical intervention because of widespread of the tumor. Local statistical data collected from the tumor registration centers in north of Iraq revealed that the incidence of KS in North of Iraq [Mousl, Erbil, and Dohuk] between years 1980-1990 was 0.6 per 100000 populations, while the incidence became 3.6 per 100000 populations between years 1991-2004 [6 folds increase] after the Second Gulf War 1991. Chest and visceral involvement by KS was extremely rare before nineties, but in the last 10 years the incidence of visceral presentations with a typical fulminating forms of Kaposi's sarcoma was frequent

Sarcoma de Kaposi: a propósito de una revisión clinicopatológica / Kaposi's sarcoma: a propose of a clinic-pathological review

Desde la aparición de la enfermedad del Sida, se ha profundizado el estudio sobre sarcoma de kaposi (SK) debido a la asociación de esta neoplasia con la infección por el virus VIH. Sin embargo, debe recordarse que existen también otras formas de sarcoma de kaposi no asociadas al Sida. Ultimamente se ha investigado la patogenia del SK y se han postulado varias teorías que explicarían el origen de esta enfermedad. En el presente trabajo, se analizan las características clínicas, histológicas, junto a la etiología de esta neoplasia, así como su tratamiento; además, se incluye el análisis del diagnóstico histológico realizado de los casos biopsiados en nuestro Departamento desde 1979 a 1994

Consideraciones sobre una remisión en un caso de enfermedad de Kaposi / Considerations on a remission in a case of Kaposis disease

Tras hacer consideraciones sobre la prolongada evolución de la enfermedad de Kaposi (clásica o europea), se relata un caso de un paciente de 73 años, con lesiones maculosas generalizadas que fue tratado con radioterapia superficial. Estas aplicaciones fueron realizadas en miembros inferiores, de acuerdo a un plan terapeútico. La regresión se produjo no sólo en la zona irradiada, sino también en las otras lesiones localizadas en miembros superiores y tronco. La mejoría clínica fue confirmada por la histopatología. Se plantean hipótesis sobre posibles mecanismos de esta insólita evolución.