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Fig. 4.35 Kaposi sarcoma of the palate. Clinical features

Classic type of KS is characterized by the appearance of purplish, reddish blue or dark brown macules, plaques and nodules that may ulcerate. They are particularly frequent in distal extremities and may be accompanied by lymphoedema. The disease is usually indolent, lymph node and visceral involvement occurs infrequently. Classic KS may be associated with haematolymphoid malignancies. In the endemic form of KS, the disease may be localized to skin and shows a protracted course. A variant of endemic disease, a lymphadenopathic form in African children is rapidly progressive and highly lethal.

Iatrogenic KS is relatively frequent. It develops in a few months to several years after the transplantation of solid organs or immunosuppressive treatment for a vari

Table 4.05 Epidemiological-clinical types of Kaposi sarcoma

Type

Risk groups

Skin lesions

Visceral involvement

Course

-predilection sites

Classic

Elderly men of Mediterranean/

Lower legs

Rare

Indolent

East European descent

Endemic

Middles-aged men and children in Equatorial Africa

Extremities

Fairly common - adults Frequent - children (lymph nodes)

Indolent - adults Aggressive - children

Iatrogenic

Immunosuppressed patients (post-transplant, other diseases)

Lower legs

Fairly common

Indolent or aggressive

AIDS-associated

Younger, mainly homo- and bisexual HIV-1 infected men

Face, genitalia, lower extremities

Frequent

Aggressive

From: WHO Classification of Tumours of Soft Tissue and Bone {775}.

Fig. 4.36 Kaposi sarcoma. A Inflammatory-like aspect of palatal Kaposi sarcoma. B Vascular slits and sparsely distributed lymphocytes.

ety of conditions. The disease may resolve entirely upon withdrawal of immunosuppressive treatment although immunosuppressive treatment although its course is somewhat unpredictable. AIDS-related KS is the most aggressive type of KS. Early oral KS is represented by solitary or multiple red or bluish flat lesions, while the later stage is characterized by a nodular, sometimes massive appearance with or without secondary ulceration.

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