Kaposi's sarcoma differential diagnosis

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]

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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, such as:

• Kaposi's sarcoma cutaneous lesions must be differentiated from:

• Bacillary angiomatosis
• Arteriovenous malformation
• Acroangiodermatitis
• Masson's hemangioma
• Angiosarcoma
• Seborrheic keratosis
• Erythematous lupus
• Pigmented purpuric dermatosis
• Pyogenic granuloma
• Benign lymphangioendothelioma
• Cavernous hemangioma
• Sarcomatoid carcinoma
• Spindle cell hemangioendothelioma

• Kaposi's sarcoma pulmonary lesions must be differentiated from:

• AIDS-related lymphoma
• Atypical pneumonia
• Fungal or mycobacterial infection
• Lung cancer

• Kaposi's sarcoma gastrointestinal lesions must be differentiated from:

• Peptic ulcer disease
• Inflammatory bowel disease (IBD)
• Gastrointestinal tract cancer

Diseases	Etiology	Congenital	Acquied	Demography	Clinical manifestations							Lab findings						Gold standard diagnosis	Additional findings
					Symptoms			Signs				CBC			LFT	ESR/CRP	Histopathology
					Appearance	Fever	Bleeding	BP	Hepatosplenomegaly	Lymphadenopathy	Other	WBC	Hb	Plt
Bacillary angiomatosis	HIV Chronic lymphocytic leukemia Cytotoxic chemotherapy Organ transplantation	-	+	Any age, usually in 20-50 years	Solitary or multiple red, purple, flesh-colored, or colorless papules	+/-	+/-	Nl	-	-	Anorexia, weight loss Abdominal pain, nausea, and vomiting Psychiatric symptoms like headache, seizure and personality changes	Nl	Nl	Nl	Nl	Nl	Lobular vascular proliferations of vessels lined by plump endothelial cells
Arteriovenous malformation
Acroangiodermatitis
Angiosarcoma
Masson's hemangioma
Seborrheic keratosis
Systemic lupus erythematosus (SLE)
Pigmented purpuric dermatosis
Pyogenic granuloma	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
Benign lymphangioendothelioma
Cavernous hemangioma
Sarcomatoid carcinoma
Spindle cell hemangioendothelioma