Kaposi's sarcoma differential diagnosis: Difference between revisions

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Revision as of 17:40, 4 October 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2] Haytham Allaham, M.D. [3]

Overview

Kaposi's sarcoma must be differentiated from other diseases that cause similar cutaneous, pulmonary, and gastrointestinal involvement, such as bacillary angiomatosis, AIDS-related lymphoma, and seborrheic keratosis.

Differentiating Kaposi's Sarcoma from other Diseases

Kaposi's sarcoma must be differentiated from other diseases that cause similar cutaneous, pulmonary, and gastrointestinal involvement.^[1]^[2]^[3]

Diseases	Etiology	Congenital	Acquired	Demography	Clinical manifestations							Lab findings						Gold standard diagnosis	Associated findings
					Symptoms			Signs				CBC			LFT	ESR/CRP	Histopathology
					Appearance	Fever	Bleeding	BP	Hepatosplenomegaly	Lymphadenopathy	Other	WBC	Hb	Plt	LFT	ESR/CRP	Histopathology
Bacillary angiomatosis ^[4]	HIV Chronic lymphocytic leukemia Cytotoxic chemotherapy Organ transplantation	–	+	Any age, usually between 20 -50 years	Solitary or multiple red, purple, flesh-colored, or colorless papules	±	±	Nl	–	–	Anorexia Weight loss Abdominal pain Nausea and vomiting Headache	Nl	Nl	Nl	Nl	Nl	Lobular vascular proliferations of vessels lined by plump endothelial cells	Clinical manifestation	Psychiatric disorders Personality changes Seizure
Arteriovenous malformation ^[5]	Idiopathic	+	–	Any age	Nl	–	+	Nl	–	–	Headache Neurologic deficits Heart failure Macrocephaly	Nl	Nl	Nl	Nl	Nl	NA	Imaging	Hereditary hemorrhagic telangiectasia
Acroangiodermatitis^[6]	Idiopathic Hyperplasia of pre-existing vasculature HTN	–	–	Any age, more in males	Purplish-blue to brown papules and plaques	–	–	Nl	–	–	Paralysed legs	Nl	Nl	Nl	Nl	Nl	Hyperkeratosis Parakeratosis Acanthosis Mild spongiosis	Clinical manifesttations	Amputation Haemodialysis patients with arteriovenous shunts Hepatitis C Chronic venous insufficiency AV malformations
Angiosarcoma ^[7]	Idiopathic	–	–	Adults, more in males	Enlarging bruise, a blue-black nodule, or an unhealed ulceration	–	–	Nl	–	–	–	Nl	↓	↓	Nl	Nl	Intercellular and intracellular lumina with or without red cells Intermediate filaments and pinocytotic vesicles in cytoplasm Weibel-Palade bodies	Biopsy	NA
Diseases	Etiology	Congenital	Acquired	Demography	Appearance	Fever	Bleeding	BP	Hepatosplenomegaly	Lymphadenopathy	Other	WBC	Hb	Plt	LFT	ESR/CRP	Histopathology	Gold standard diagnosis	Associated findings
Masson's hemangioma ^[8]	Idiopathic	–	–	Rare	Normal	–	–	Nl	–	–	–	Nl	Nl	Nl	Nl	Nl	Papillary fronds lined by proliferating endothelium	Biopsy	Hemangioma Pyogenic granulomas Lymphangiomas
Seborrheic keratosis ^[9]	Clonal expansion of a mutated epidermal keratinocyte	+	–	Any age	Usually asymptomatic Being stuck on the skin surface	–	–	Nl	–	–	–	Nl	Nl	Nl	Nl	Nl	Papillomatous epithelial proliferation containing horn cysts	Clinical manifestations	Dermatosis papulosa nigra Stucco keratosis Melanoacanthoma Polypoid lesions
Systemic lupus erythematosus (SLE) ^[10]	Idiopathic	–	–	More common in female, typically in the 20 to 30 years	Erythema on the nasolabial folds Macular or diffusely erythematous in sun-exposed areas Discoid rash	±	-	↑	±	±	Weight loss Headache Arthralgia Myalgia Nausea Dyspepsia Pleuritic chest pain Dyspnea Hematuria	↑	↓	↓	Nl	Nl	Hyperkeratosis, epidermal atrophy, vacuolar interface dermatitis Thickening of the basement membrane Superficial, perivascular, and perifollicular mononuclear cell inflammatory infiltrate	Clinical manifestations	Raynaud phenomenon Neuropsychiatric symptoms Pleural effusion Peptic ulcer disease Pericarditis Myocarditis
Pyogenic granuloma ^[11]	Trauma Hormonal influences Viruses Cytogenetic clonal deletion abnormalities	+	+	Any age, usually in 20-30 years	Painless red lesion Lobular capillary hemangioma	–	+	Nl	–	–	–	Nl	Nl	Nl	Nl	Nl	Neutrophilic infiltration Hemorrhage Necrosis of the overlying epidermis	Clinical manifestation	NA
Benign lymphangioendothelioma ^[12]	Idiopathic	–	+	Any ages, median age is 50 years	single, slowly expanding patch, plaque, or nodule	–	–	Nl	–	–	–	Nl	Nl	Nl	Nl	Nl	Thin-walled endothelial-lined spaces that are interspersed between strands of collagen	Biopsy	NA
Cavernous hemangioma ^[13]	Idiopathic	–	–	Usually in third to fifth decades of life.	Painless, slowly progressive protrusion or bulging of their globe	–	–	Nl	–	–	–	Nl	Nl	Nl	Nl	Nl	Engorged vascular channels, which are tightly knit and separated by fibrous septae	Clinical manidestation	Diplopia Decreased color vision Visual field deficits
Diseases	Etiology	Congenital	Acquired	Demography	Appearance	Fever	Bleeding	BP	Hepatosplenomegaly	Lymphadenopathy	Other	WBC	Hb	Plt	LFT	ESR/CRP	Histopathology	Gold standard diagnosis	Associated findings

References

↑ Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016
↑ Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016
↑ Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015
↑ Tappero JW, Perkins BA, Wenger JD, Berger TG (July 1995). "Cutaneous manifestations of opportunistic infections in patients infected with human immunodeficiency virus". Clin. Microbiol. Rev. 8 (3): 440–50. PMC 174635. PMID 7553576.
↑ Whitehead KJ, Smith MC, Li DY (February 2013). "Arteriovenous malformations and other vascular malformation syndromes". Cold Spring Harb Perspect Med. 3 (2): a006635. doi:10.1101/cshperspect.a006635. PMC 3552339. PMID 23125071.
↑ Lugović L, Pusić J, Situm M, Buljan M, Bulat V, Sebetić K, Soldo-Belić A (2007). "Acroangiodermatitis (pseudo-Kaposi sarcoma): three case reports". Acta Dermatovenerol Croat. 15 (3): 152–7. PMID 17868541.
↑ Barttelbort SW, Stahl R, Ariyan S (July 1989). "Cutaneous angiosarcoma of the face and scalp". Plast. Reconstr. Surg. 84 (1): 55–9. PMID 2734404.
↑ Park KK, Won YS, Yang JY, Choi CS, Han KY (July 2012). "Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review". J Korean Neurosurg Soc. 52 (1): 52–4. doi:10.3340/jkns.2012.52.1.52. PMC 3440504. PMID 22993679.
↑ Noiles K, Vender R (2008). "Are all seborrheic keratoses benign? Review of the typical lesion and its variants". J Cutan Med Surg. 12 (5): 203–10. doi:10.2310/7750.2008.07096. PMID 18845088.
↑ Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P (2012). "Cutaneous manifestations of systemic lupus erythematosus". Autoimmune Dis. 2012: 834291. doi:10.1155/2012/834291. PMC 3410306. PMID 22888407.
↑ Kamal R, Dahiya P, Puri A (January 2012). "Oral pyogenic granuloma: Various concepts of etiopathogenesis". J Oral Maxillofac Pathol. 16 (1): 79–82. doi:10.4103/0973-029X.92978. PMC 3303528. PMID 22434943.
↑ Guillou L, Fletcher CD (August 2000). "Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series". Am. J. Surg. Pathol. 24 (8): 1047–57. PMID 10935645.
↑ Goldberg RE, Pheasant TR, Shields JA (December 1979). "Cavernous hemangioma of the retina. A four-generation pedigree with neurocutaneous manifestations and an example of bilateral retinal involvement". Arch. Ophthalmol. 97 (12): 2321–4. PMID 229814.

Template:WH Template:WS

[radio-1] Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016

[patho-2] Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016

[patho2-3] Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015

[pmid7553576-4] Tappero JW, Perkins BA, Wenger JD, Berger TG (July 1995). "Cutaneous manifestations of opportunistic infections in patients infected with human immunodeficiency virus". Clin. Microbiol. Rev. 8 (3): 440–50. PMC 174635. PMID 7553576.

[pmid23125071-5] Whitehead KJ, Smith MC, Li DY (February 2013). "Arteriovenous malformations and other vascular malformation syndromes". Cold Spring Harb Perspect Med. 3 (2): a006635. doi:10.1101/cshperspect.a006635. PMC 3552339. PMID 23125071.

[pmid17868541-6] Lugović L, Pusić J, Situm M, Buljan M, Bulat V, Sebetić K, Soldo-Belić A (2007). "Acroangiodermatitis (pseudo-Kaposi sarcoma): three case reports". Acta Dermatovenerol Croat. 15 (3): 152–7. PMID 17868541.

[pmid2734404-7] Barttelbort SW, Stahl R, Ariyan S (July 1989). "Cutaneous angiosarcoma of the face and scalp". Plast. Reconstr. Surg. 84 (1): 55–9. PMID 2734404.

[pmid22993679-8] Park KK, Won YS, Yang JY, Choi CS, Han KY (July 2012). "Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review". J Korean Neurosurg Soc. 52 (1): 52–4. doi:10.3340/jkns.2012.52.1.52. PMC 3440504. PMID 22993679.

[pmid18845088-9] Noiles K, Vender R (2008). "Are all seborrheic keratoses benign? Review of the typical lesion and its variants". J Cutan Med Surg. 12 (5): 203–10. doi:10.2310/7750.2008.07096. PMID 18845088.

[pmid22888407-10] Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P (2012). "Cutaneous manifestations of systemic lupus erythematosus". Autoimmune Dis. 2012: 834291. doi:10.1155/2012/834291. PMC 3410306. PMID 22888407.

[pmid22434943-11] Kamal R, Dahiya P, Puri A (January 2012). "Oral pyogenic granuloma: Various concepts of etiopathogenesis". J Oral Maxillofac Pathol. 16 (1): 79–82. doi:10.4103/0973-029X.92978. PMC 3303528. PMID 22434943.

[pmid10935645-12] Guillou L, Fletcher CD (August 2000). "Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series". Am. J. Surg. Pathol. 24 (8): 1047–57. PMID 10935645.

[pmid229814-13] Goldberg RE, Pheasant TR, Shields JA (December 1979). "Cavernous hemangioma of the retina. A four-generation pedigree with neurocutaneous manifestations and an example of bilateral retinal involvement". Arch. Ophthalmol. 97 (12): 2321–4. PMID 229814.

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@@ Line 274: / Line 274: @@
 | style="background:#F5F5F5;" align="center" | ↓
 | style="background:#F5F5F5;" align="center" | ↓
-| style="background:#F5F5F5;" align="center" | -
+| style="background:#F5F5F5;" align="center" |Nl
 | style="background:#F5F5F5;" align="center" | Nl
 | style="background:#F5F5F5;" align="center" |
-* Hyperkeratosis, epidermal atrophy, vacuolar interface dermatitis
+* [[Hyperkeratosis]], epidermal [[atrophy]], vacuolar interface [[dermatitis]]
-* Thickening of the basement membrane
+* Thickening of the [[basement membrane]]
-* Superficial, perivascular, and perifollicular mononuclear cell inflammatory infiltrate
+* Superficial, [[Perivascular cell|perivascular]], and perifollicular [[Monocyte|mononuclear cell]] inflammatory infiltrate
 | style="background:#F5F5F5;" align="center" | Clinical manifestations
 | style="background:#F5F5F5;" align="center" |
-* Raynaud phenomenon
+* [[Raynaud's phenomenon|Raynaud phenomenon]]
-* Neuropsychiatric symptoms
+* [[Neuropsychiatry|Neuropsychiatric]] symptoms
-* Pleural effusion
+* [[Pleural effusion]]
-* Peptic ulcer diseas
+* [[Peptic ulcer|Peptic ulcer disease]]
-* Pericarditis
+* [[Pericarditis]]
-* Myocarditis
+* [[Myocarditis]]
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pyogenic]] granuloma <ref name="pmid22434943">{{cite journal |vauthors=Kamal R, Dahiya P, Puri A |title=Oral pyogenic granuloma: Various concepts of etiopathogenesis |journal=J Oral Maxillofac Pathol |volume=16 |issue=1 |pages=79–82 |date=January 2012 |pmid=22434943 |pmc=3303528 |doi=10.4103/0973-029X.92978 |url=}}</ref>
 | style="background:#F5F5F5;" align="center" |
-* Trauma
+* [[Physical trauma|Trauma]]
 * Hormonal influences
-* Viruses
+* [[Virus|Viruses]]
 * Cytogenetic clonal deletion abnormalities
@@ Line 302: / Line 302: @@
 | style="background:#F5F5F5;" align="center" | +
 | style="background:#F5F5F5;" align="center" | Any age, usually in 20-30 years
-| style="background:#F5F5F5;" align="center" | Painless red lesion (lobular capillary hemangioma)
+| style="background:#F5F5F5;" align="center" |
+* Painless red lesion
+* Lobular [[capillary hemangioma]]
 | style="background:#F5F5F5;" align="center" | –
 | style="background:#F5F5F5;" align="center" | +
@@ Line 314: / Line 316: @@
 | style="background:#F5F5F5;" align="center" | Nl
 | style="background:#F5F5F5;" align="center" | Nl
-| style="background:#F5F5F5;" align="center" | Neutrophilic infiltration, hemorrhage, necrosis of the overlying epidermis
+| style="background:#F5F5F5;" align="center" |
+* Neutrophilic infiltration
+* [[Bleeding|Hemorrhage]]
+* [[Necrosis]] of the overlying [[Epidermis (skin)|epidermis]]
 | style="background:#F5F5F5;" align="center" | Clinical manifestation
-| style="background:#F5F5F5;" align="center" | -
+| style="background:#F5F5F5;" align="center" |NA
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Benign lymphangioendothelioma <ref name="pmid10935645">{{cite journal |vauthors=Guillou L, Fletcher CD |title=Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series |journal=Am. J. Surg. Pathol. |volume=24 |issue=8 |pages=1047–57 |date=August 2000 |pmid=10935645 |doi= |url=}}</ref>
@@ Line 326: / Line 331: @@
 | style="background:#F5F5F5;" align="center" | +
 | style="background:#F5F5F5;" align="center" | Any ages, median age is 50 years
-| style="background:#F5F5F5;" align="center" | single, slowly expanding patch, plaque, or nodule
+| style="background:#F5F5F5;" align="center" |
+* single, slowly expanding patch, [[plaque]], or [[Nodule (medicine)|nodule]]
 | style="background:#F5F5F5;" align="center" | –
 | style="background:#F5F5F5;" align="center" | –
@@ Line 338: / Line 344: @@
 | style="background:#F5F5F5;" align="center" | Nl
 | style="background:#F5F5F5;" align="center" | Nl
-| style="background:#F5F5F5;" align="center" | Thin-walled endothelial-lined spaces that are interspersed between strands of collagen
+| style="background:#F5F5F5;" align="center" |
-| style="background:#F5F5F5;" align="center" | Clinical manifestation and biopsy
+* Thin-walled endothelial-lined spaces that are interspersed between strands of [[collagen]]
-| style="background:#F5F5F5;" align="center" | -
+| style="background:#F5F5F5;" align="center" |[[Biopsy]]
+| style="background:#F5F5F5;" align="center" |NA
 |-
 | style="background: #DCDCDC; padding: 5px; text-align: center;" |Cavernous [[hemangioma]] <ref name="pmid229814">{{cite journal |vauthors=Goldberg RE, Pheasant TR, Shields JA |title=Cavernous hemangioma of the retina. A four-generation pedigree with neurocutaneous manifestations and an example of bilateral retinal involvement |journal=Arch. Ophthalmol. |volume=97 |issue=12 |pages=2321–4 |date=December 1979 |pmid=229814 |doi= |url=}}</ref>
@@ Line 350: / Line 357: @@
 | style="background:#F5F5F5;" align="center" | –
 | style="background:#F5F5F5;" align="center" | Usually in third to fifth decades of life.
-| style="background:#F5F5F5;" align="center" | Painless, slowly progressive protrusion or bulging of their globe
+| style="background:#F5F5F5;" align="center" |
+* Painless, slowly progressive protrusion or bulging of their globe
 | style="background:#F5F5F5;" align="center" | –
 | style="background:#F5F5F5;" align="center" | –
@@ Line 362: / Line 370: @@
 | style="background:#F5F5F5;" align="center" | Nl
 | style="background:#F5F5F5;" align="center" | Nl
-| style="background:#F5F5F5;" align="center" | Engorged vascular channels, which are tightly knit and separated by fibrous septae
+| style="background:#F5F5F5;" align="center" |
+* Engorged vascular channels, which are tightly knit and separated by [[Fiber|fibrous]] septae
 | style="background:#F5F5F5;" align="center" | Clinical manidestation
 | style="background:#F5F5F5;" align="center" |
-* Diplopia
+* [[Diplopia]]
-* Decreased color vision
+* Decreased [[color vision]]
-* Visual field deficits
+* [[Visual field loss|Visual field deficits]]
 |-
-|
+|Diseases
-|
+|Etiology
-|
+|Congenital
-|
+|Acquired
-|
+|Demography
-|
+!Appearance
-|
+!Fever
-|
+!Bleeding
-|
+!BP
-|
+!Hepatosplenomegaly
-|
+!Lymphadenopathy
-|
+!Other
-|
+!WBC
-|
+!Hb
-|
+!Plt
-|
+|LFT
-|
+|ESR/CRP
-|
+|Histopathology
-|
+|Gold standard diagnosis
-|
+|Associated findings
 |}

Kaposi's sarcoma differential diagnosis: Difference between revisions

Revision as of 17:40, 4 October 2018

Overview

Differentiating Kaposi's Sarcoma from other Diseases

References

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