Department of Dermatology Farhat Hached University Hospital, Sousse, Tunisia;
Department of Dermatology Farhat Hached University Hospital, Sousse, Tunisia.
Skinmed. 2020 Dec 1;18(6):378-379. eCollection 2020.
An 81-year-old woman presented with a 2-month history of a painless nodule on the left foot that bled easily after minor trauma. She had no medical history and did not report any preexisting lesion. Physical examination revealed a 2 cm × 3 cm, exophytic and reddish-colored nodule, with an ulcerated and soft surface (Figure 1). There were no other skin lesions or abnormal physical findings. The diagnosis of a pyogenic granuloma (PG) was suggested. A biopsy specimen was obtained from the center of the lesion and stained with hematoxylin and eosin. Histopathologic examination revealed a marked proliferation of both capillary cells and spindle-shaped cells separated by slit-like vessels containing multiple erythrocytes (Figure 2A). Immunochemical analysis showed positivity for CD34 and (HHV)-8 in both endothelial and spindle cells (Figure 2B). Perls' staining showed abundant hemosiderin deposits in the tumor stroma (Figure 2C). These findings were consistent with the diagnosis of Kaposi sarcoma (KS). Laboratory tests eliminated a human immunodeficiency virus (HIV) infection, and no metastatic lesions were found on radiologic examinations. The lesion was treated with laser excision, with no recurrence at the 2-year follow-up.
一位 81 岁女性因左足无痛性结节就诊，该结节在轻微外伤后容易出血，病史 2 个月。她无既往病史，也未报告任何原有皮损。体格检查发现一个 2 cm×3 cm 的外生性、红色结节，表面溃疡、质软（图 1）。无其他皮肤损害或异常的体格检查发现。临床诊断为化脓性肉芽肿（PG）。从病变中心取活检标本，行苏木精-伊红染色。组织病理学检查显示，毛细血管细胞和梭形细胞明显增生，分隔开裂隙状血管，内含多个红细胞（图 2A）。免疫组织化学分析显示内皮细胞和梭形细胞均表达 CD34 和 HHV-8（图 2B）。普鲁士蓝染色显示肿瘤基质中含有丰富的含铁血黄素沉积（图 2C）。这些发现与卡波西肉瘤（KS）的诊断相符。实验室检查排除了人类免疫缺陷病毒（HIV）感染，影像学检查也未发现转移病灶。病变采用激光切除治疗，2 年随访时无复发。
