Endoscopic ultrasound in the diagnosis and staging of gastrointestinal Kaposi's sarcoma.

BACKGROUND AND STUDY AIMS

Endoscopic ultrasonography (EUS) has been evaluated for diagnosing and staging of a variety of gastrointestinal tumors, but there are no data on EUS in Kaposi's sarcoma (KS). The aim of the present study was to evaluate the role of EUS in addition to endoscopy in the diagnosis and staging of patients with established or suspected upper gastrointestinal KS.

PATIENTS AND METHODS

22 male acquired immune deficiency syndrome (AIDS) patients were prospectively studied, three of them before and after chemotherapy with liposomal doxorubicin. The features of gastrointestinal KS were recorded, and EUS was assessed for diagnosis in endoscopically negative or inconclusive cases, and for staging in endoscopically visible KS lesions.

RESULTS

The typical EUS feature of KS was a hypoechoic and nonhomogeneous lesion leading predominantly to mucosal and submucosal thickening, whereas a few lesions presented only with submucosal involvement. EUS detected suspicious lesions in two patients with negative endoscopy, which turned out to be KS on follow-up. Restaging after chemotherapy in three patients showed regression of lesions both on endoscopy and EUS.

CONCLUSIONS

EUS may contribute to better detection of early KS lesions and a more reliable delineation of the extent of gastrointestinal KS, which is valuable for assessing the effect of various forms of therapy.