How to check Kaposi's sarcoma? Here are three methods

Among common tumor diseases, the incidence of Kaposi's sarcoma is very high. Generally speaking, when people diagnose the disease, they should also read more about the relevant methods. So, how to check Kaposi's sarcoma?

1. General examination

Skin lesions (spots, plaques, nodules) range in diameter from very small to several centimeters. Lesions of the mucosa, soft tissue, lymph nodes and internal organs manifest as hemorrhagic nodules of varying sizes, which may fuse with each other.

2. Histopathology

The 4 different epidemiologic-clinical types of KS are microscopically indistinguishable. Early skin lesions are non-characteristic and show mild vascular proliferation.

During the macular stage, the number of blood vessels increases and their shape becomes irregular, separating the collagen fibers in the reticular layer of the upper dermis. The direction of blood vessels is generally parallel to the epidermis, and the sites of hyperplasia are often around blood vessels and appendages. There are small numbers of lymphocytes and plasma cells admixed in the lesions. Extravascular erythrocytes and perivascular hemosiderin deposits are common.

All macular lesions further worsen during the plaque phase. Vascular proliferation is more diffuse, the outline of the vascular space is jagged, and the inflammatory cell infiltration is more obvious, with a large number of extravascular red blood cells and hemosiderin. Glass globules are often found.

In the nodular stage, interdigitating bundles of spindle cells with only mild atypia form well-defined nodules and numerous slit-like spaces containing red blood cells. There are dilated blood vessels in the peripheral part of the lesion. Many spindle cells are actively dividing. Hyaline globules are present inside and outside the spindle cells.

Lesions in lymph nodes may be unifocal or multifocal and may be completely replaced by tumor tissue. Visceral organ lesions vary depending on the structure of the affected organ, spreading along structures such as blood vessels, bronchi, and liver portal vein, and then affecting the surrounding organ parenchyma.

3. Immunophenotype

Endothelial cells that form well-formed blood vessels are generally positive for vascular markers, spindle cells are persistently positive for CD34, often positive for CD31, and negative for factor VIII. HHV8 was positive and FLI1 was almost 100% expressed.