| Theme | Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders | |
|---|---|---|
| Title | Gastrointestinal Kaposi's sarcoma in AIDS patients | |
| Publish Date | 2008/01 | |
| Author | Naoyoshi Nagata | Department of Gastroenterology, International Medical Center of Japan, Tokyo |
| Author | Tomoyuki Yada | Department of Gastroenterology, International Medical Center of Japan, Tokyo |
| Author | Keita Sasajima | Department of Gastroenterology, International Medical Center of Japan, Tokyo |
| Author | Junichi Akiyama | Department of Gastroenterology, International Medical Center of Japan, Tokyo |
| Author | Naomi Uemura | Department of Gastroenterology, International Medical Center of Japan, Tokyo |
| Author | Yoshimi Kikuchi | Department of AIDS Clinical Center, International Medical Center of Japan, Tokyo |
| Author | Yoshiro Tamegai | Department of Endoscope Center, Seirei Yokohama Hospital |
| [ Summary ] | Kaposi's sarcma (KS) is the most common neoplasm in patients with AIDS. This disease is common among homosexual men and HHV-8 has been indicated as playing a role in its pathogenesis. With KS the gastrointestinal tract is the third most affected site after the skin and the lymphnodes. Most gastrointestinal KS lesions are asymptomatic, but advanced lesions may cause gastrointestinal hemorrhaging and obstructions that require immediate treatment. Gastrointestinal KS is detected by endoscopic appearance, such as submucosal nodule lesions, with red mucosa. Sometimes, there is depression on the top and polypoid features. A previous report demonstrated that only l9 - 3l % of endoscopically biopsied lesions tested positive for KS. However, in our study, 80 % of these lesion were diagnosed by means of endoscopic biopsy. Biopsy speciments revealed typical spidle cell tumors with numerous vascular slits and hemorrhaging. In treating visceral lesions multidrug chemotherapy such as ABV has been commonly used. However, in recent years, HAART appears to have displayed some efficacy for AIDS-KS treatment. In addition prognoses have improved with the use of new drug such as liposomal doxorubicin. In Japan, the number of patients with HIV infection is still increasing. Physicians should be familiar with the endoscopic findings of AIDS related gastrointestinal lesions, especially malignant tumors. It is important to diagnose gastrointestinal KS with endoscopy at an early stage. |
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