Clinicopathological changes of renal transplantation related Kaposi's sarcoma / 中国癌症杂志

ABSTRACT

Background and Purpose:Kaposi's sarcoma(KS) cases occurring in renal allograph recipients was considered to be due to long-term immunosuppressive therapy.But the exact carcinogenetic process has not been elucidated so far.The lesions could not be distinguished from other KS types by histopathological study.Endemic KS cases seemed to be more common in Xinjiang,especially in the Uygur ethnic group,and their relation to other types of KS was investigated in three cases by histopathology and immunohistochemistry for the present study.Methods:Biopsy specimens from three cases of renal tronsplantation related KS,including two Uygur and one Han patients,were obtained from this hospital(No.474 hospital of PLA).Formalin-fixed and paraffin embedded blocks were cut for routine HE and immunohistochemical staining to study respectively.Monoantibodies of CD34,Ⅷ-factor,Vimentin,actin and FN were detected by S-P techniques for immunohistochemistry.Results:Histopathologically,the typical histology of traditional KS was found in almost all the specimens of the three patients.In the early stage of the disease,there are only a few vessel fissures with irregular dilation and clustering obese(epithelioid)cells.In the middle stage,the changes are wider in scope with proliferation of spindle cells,in the form of beams and weaves.The proliferating vessels are dilated and hyperemic around the lesion.In the late stage,the spindle cells proliferation are markedly atypical,and karyokinesis is increased.Immunohistochemistry showed CD34 to be more strongly positive,Ⅷ-Factor(+),Vimentin(+) showed a weak reation;while actin(-),FN(-) were negative.Conclusions:Renal transplantation related KS is not essentially different from other types of KS both in histopathohogy and immunohistochemical characters which may reflect that they have a similar etiopathogenetic procession.However,the distinctive distribution of morbidity among different ethnic groups or districts strongly suggested that the genetic background plays a critical role on KS carcinogenesis.