Case Number : Case 2210 - 28 November 2018 Posted By: Dr. Hafeez Diwan

Kaposi's Sarcoma or kaposiform hemangioendothelioma

kaposi sarcoma

Kaposiform Hemangioendothelioma.

Ill define lobules of spindle and epithelioid cells arranged in short fascicles, intracitoplasmic erythrocytes, fibrin microthrombi.

Difficult lesion for me.

Yes it could be a Kaposi Sarcoma and obviously i will do a HHV8 in this case. But i would like to add some differentials: Spindle cell hemangioma (yes, it lack the cavernous areas) and (cellular) nodular fascitis.

Vascular tumor for me. First hypothesis was spindle cell hemangioma although kaposiform hemangioendothelioma cannot be ruled out only based on these images. That being said, kaposiform hemangioendothelioma is a rare neoplasm that tends to have a specific clinical setting (young patients, limited to an area of the body +/- kasabach Merritt syndrome). Out of that context we should be really careful before rendering such diagnosis. I agree with you guys that we should perform HHV8 in this case

The histology is enough in keeping with both: KHE( kaposiform areas with lobulated pattern and some glomeruloid pattern) and Spindle Cell Hemangioma(nice vacuolated endothelial cells, but only the kaposiform component without the cavernous one). I'm not sure, but would agree with Victor as first  spot! 

HHV8 was negative. I ended up calling this spindle cell hemangioma.