Kaposi’s sarcoma

Case 26   July 2010 (P. McKee)  RBC’s; Plasma cells; haemosiderin = Kaposi’s (patch stage)  Doesn’t show the typical slit-like vascular spaces seen in later stages 

Case 54   Aug 2010 (P. McKee)  lymphangiomatous. Promontory sign. 

Case 278  July 2011 (P. McKee)  M 23 purpuric lesions trunk and oral cavity (*teaching) 

Very good example. Promontory sign; haemosiderin 

Case 460   Mar 2012 (P. McKee)  M 17 pigmented lesions on trunk 

Vessels with promontory sign, spindle cells, inflammatory cells incl. plasma cells, spindle cells. 

Case 464  Mar 2012  (P. McKee)  M 18 purpuric plaques 

Case 488   April 2012  (P. McKee)  M 32 rapidly growing tumour on tongue 

Spindle celled vascular tumour.  Lots of plasma cells.  One small granuloma - ? fungal. 

Case 504  May 2012 (IH Chaudhry)  M 33 thigh lesion 

Slit-like vessels between collagen bundles with a lot of RBC extravasation.  Somewhat interstitial GA-like pattern to it. 

Case 617  19.10.12 (P. McKee)  M 40 haemorrhagic nodule, arm 

Nodular stage KS 

Case 655   12.12.12 (P. McKee)  M 37 plaques and nodules 

Nodular stage 

Case 664  27.12.12  (W. Grayson/P. McKee)  no clinical clues 

Only two HP views.  Eosinophilic hyaline globules well shown. These spherical intracytoplasmic eosinophilic droplets have been associated with a variety of conditions, including hepatocellular carcinoma, lung adenocarcinoma, and Kaposi's sarcoma. 

DD: epithelioid haemangioendothelioma – tumour cells are dispersed in a myxoid and hyaline stroma and show intracytoplasmic lumena. 

Case 797  8.7.13  (M Hurt)  M 74 

Looked like angiosarcoma but HHV8+ve.  Promontory sign visible – small vessels protruding into larger vascular space. 

Case 909  12.12.13 (H. Diwan)  M 24 arm lesions 

Patch stage without extravasated RBC’s or obvious plasma cells. Jagged vascular spaces dissecting collagen and ?promontory sign.  HHV8+ve 

DD: microvenular haemangioma – site typical but usually solitary; pericytes (SMA+ve) and infiltration of arrector pili muscles (not seen here); hobnail haemangioma – very rarely are these multiple, and cytology not seen here. 

Case 931  16.1.14  (H. Diwan)  M 40 arm (*teaching) 

Classical teaching histology 

Case 1025 28.5.14  (H. Diwan)  F  81 lesions toes. 

Typical histology.  HHV8 +ve. 

Case 1095  3.9.14  (H. Diwan)  M 29 back 

Only 2 of 4 slides visible, so difficult to make the diagnosis.  HHV8 was +ve apparently. 

Case 1131 23.10.14 (H. Diwan)  M 63 from Ghana.  Leg swelling and papules sole 

Only one slide visible.  Difficult to see detail.  Not a good example. 

Case 1154  25.11.14 (U. Sundram)  M 45 violaceous and erythematous lesions (*teaching)  

Patch stage before typical slit-like spaces obvious 

Case 1328   27.7.15 (M. Hurt)  M 55 hyperpigmented lesions arm (*teaching) 

Pigmented skin.  Patch stage.  Promontory sign. 

Case 1386  15.10.15  (H. Diwan)  M 30 abdo 

Not all slides visible.  LP looks like DF architecture.  HP shows hyperchromatic spindle cells dissecting collagen with haemosiderin.  IH HHV8 +ve 

Case 1482  29.2.16 (M. Hurt)  M 40 HIV +ve 

This had an interstitial pattern to it.  Vessels not at all obvious.  Hyperchromatic endothelial cells.  HHV8+ve. 

Case 1619  8.9.16 (H. Diwan)  M 74 mass foot 

Nodular stage 

Case 2062  2.5.18  (H. Diwan)  M 34 chest (*teaching) 

HHV8 +ve.  Spindle cells were too hyperchromatic for a benign diagnosis such as inflammatory morphoea 

Case 2072  16.5.18  (H. Diwan)  M 61 leg pigmentary alteration 

Macular stage.  Subtle increase in dermal spindle cells with pigment and some mucin.  Slightly atypical cytology.  HHV8 +ve. 

Case 2102 27.6.18  (H. Diwan) M 58 thigh (HHV8+ve)  

Case 2103  28.6.18 (R. Perret)  M 37 tumour, arm (*teaching)  

Ulcerated nodular stage 

Case 2225 19.12.18   (H. Diwan) M 30 pigmented plaque forearm 

Subtle early case (patch stage) with thin sinusoidal vessels with prominent endothelial cells – v. little RBC’s.    Quite a bit of mucin in dermis, simulating interstitial granulomatous dermatitis.  Also v. obvious plasma cells - ? patient with HIV and syphilis.  HHV8 was +ve. 

Case 2200  14.11.18  (H. Diwan)  M 51 violaceous patch lower leg 

Typical morphology and cytology 

Case 2819  27.4.21 (U Sundram)  M 30 purpuric lesions 

Patch stage. Promontory sign.  HHV8+ve. 

Case 2843  31.5.21 (M. Abdel-Halim)  M 70 violaceous plaques hands, feet and legs. 

Plaque stage.  Good promontory sign in last image. 

Case 2875 14.7.21 (H. Diwan)  M 39 pain and leg swelling.  Groin papules. 

Typical.  HHV8 +ve. 

Case 4009  2.6.22 (S. Taibjee) M 76 exophytic papule, toe. 

Not many slit-like spaces, promontory signs or plasma cells.  However, HHV8 and CD34 +ve.  

Case 4200 24.2.23 (IH Chaudhury)  M 54 Ankle biopsy.  HIV on retrovirals 

Nuclear staining with HHV8. 

Case 4246  1.5.23 (M. Abdel-Halim) F 54 post renal transplantation. Widespread nodules 

Promontory sign +ve. 

Case 4336  4.9.23 (M. Abdel-Halim)  M 34 reddish plaques nose, abdo, legs 

Case 4557 21.10.24 (J. Costa-Rosa) M 72 erythematous plaques on limbs 

Lymphangiomatous variant.