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.[1][2][3]
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:[1][2][3]
- 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:
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 [4] |
|
- | + | Any age, usually in 20-50 years | Solitary or multiple red, purple, flesh-colored, or colorless papules | +/- | +/- | Nl | - | - |
|
Nl | Nl | Nl | Nl | Nl | Lobular vascular proliferations of vessels lined by plump endothelial cells | Clinical manifestation |
|
Arteriovenous malformation [5] | Idiopathic
|
+ | - | Any age | Nl | - | + | Nl | - | - |
|
Nl | Nl | Nl | Nl | Nl | N/A | Imaging |
|
Acroangiodermatitis [6] | Idioathic | - | - | More frequent in male, any ages | Purplish-blue to brown papules and plaques | - | - | Nl | - | - | - | Nl | Nl | Nl | Nl | Nl | Hyperkeratosis, parakeratosis, acanthosis, and mild spongiosis | Clinical manifesttations |
|
Angiosarcoma [7] | Idiopathic | - | - | More frequent in males, usually in adults | Enlarging bruise, a blue-black nodule, or an unhealed ulceration | - | - | Nl | - | - | - | Nl | ↓ | ↓ | Nl | Nl |
|
Biopsy | - |
Masson's hemangioma [8] | Idiopathic | - | - | N/A | - | - | Nl | - | - | - | Nl | Nl | Nl | Nl | Nl | Papillary fronds lined by proliferating endothelium | Clinical manifestations and histological findings |
| |
Seborrheic keratosis [9] | Clonal expansion of a mutated epidermal keratinocyte | + | - | Any age |
|
- | - | Nl | - | - | - | Nl | Nl | Nl | Nl | Nl | Papillomatous epithelial proliferation containing horn cysts | Clinical manifestations |
|
Systemic lupus erythematosus (SLE) [10] | Idiopathic | - | - | More coomon in female, typically in the 20 to 30 years |
|
+/- | - | ↑ | +/- | +/- |
|
↑ | ↓ | ↓ | - | Nl |
|
Clinical manifestations |
|
Pyogenic granuloma [11] |
|
+ | + | 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 | - |
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 | Clinical manifestation and biopsy | - |
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 |
|
References
- ↑ 1.0 1.1 Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016
- ↑ 2.0 2.1 Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016
- ↑ 3.0 3.1 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.