Yu Yue, Demierre Marie-France, Mahalingam Meera
Department of Dermatology, Boston University School of Medicine, Boston, MA, USA.
J Cutan Pathol. 2010 Oct;37(10):1088-91. doi: 10.1111/j.1600-0560.2009.01389.x. Epub 2009 Jul 22.
Anaplastic Kaposi sarcoma (KS) is an uncommon histologic phenotype of Kaposi's and one that is typically associated with a locally aggressive clinical course. We report a case of a 53-year-old human immunodeficiency virus-positive male, on highly active antiretroviral therapy 1 month prior to admission, who presented with fever, cough, respiratory distress, multiple skin lesions and cervical and inguinal lymphadenopathy not responding to multiple antibiotics. Microscopic examination of punch biopsies from the forehead and chest revealed a spindled cell neoplasm with marked cytologic atypia and scattered mitoses, features consistent with a diagnosis of anaplastic KS and confirmed by immunohistochemistry with HHV-8. Biopsy of an involved lymph node also revealed involvement by KS. Despite aggressive clinical treatment, the patient rapidly deteriorated and expired 1 week after the diagnosis of anaplastic KS was rendered. Our case underscores the aggressive clinical course of this uncommon histologic variant of KS and its recalcitrant clinical behavior.
间变性卡波西肉瘤（KS）是卡波西肉瘤一种不常见的组织学表型，通常与局部侵袭性临床病程相关。我们报告一例53岁的男性艾滋病病毒阳性患者，入院前1个月正在接受高效抗逆转录病毒治疗，该患者出现发热、咳嗽、呼吸窘迫、多处皮肤病变以及颈部和腹股沟淋巴结肿大，多种抗生素治疗无效。对前额和胸部的打孔活检组织进行显微镜检查，发现为梭形细胞瘤，具有明显的细胞异型性和散在的有丝分裂，这些特征符合间变性KS的诊断，并经HHV-8免疫组化证实。受累淋巴结的活检也显示有KS累及。尽管进行了积极的临床治疗，但在间变性KS诊断后1周，患者病情迅速恶化并死亡。我们的病例强调了这种不常见的KS组织学变异型的侵袭性临床病程及其顽固的临床行为。
