ks common tumor in immunosuppressed

1. KAPOSI SARCOMA
HABAKUK LARRY OMONDI

2. Introduction
• A multifocal systemic tumor of endothelial
cell origin.
• linked with human herpesvirus 8 infection
• Has Four clinical variants
• Responds to radiation and chemotherapy,

3. Clinical variants of KS
• classic KS
• endemic African KS
• immunosuppressive therapy–related KS
• HIV/AIDS-related KS

4. Classic KS
• Occurs in elderly males of eastern
European heritage.
• Predominantly arises on the legs but also
occurs in lymph nodes and abdominal
viscera.
• slow progression and has good prognosis

5. African-Endemic KS
• bimodal age distribution young adults, mean
age 35; and young children, mean age 3
years
• Males > females
• Has poor prognosis (young adults 5–8 years;
young children 2–3 years)
• Four clinical patterns

6. African-Endemic KS patterns
a) Nodular type: benign course and resembles classic
KS.
b) Florid or vegetating type: more aggressive. Nodular
extend deeply into the subcutis, muscle, and bone.
c) Infiltrative type: more aggressive has
mucocutaneous and visceral .
d) Lymphadenopathic type: children and young adults.
confined to lymph nodes and viscera, also involves
the skin and mucous membrane.

7. Iatrogenic Immunosuppression-
Associated KS
• Rare.
• Most commonly in solid-organ transplant
recipients
• chronic use of immunosuppressive drugs
• Resolves on cessation of
immunosuppression.

8. HIV/AIDS-Associated KS
• AIDS increases risk of KS ( 20,000 times that
those not infected with HIV)
• Common in homosexual men
• Rapid progression, extensive systemic
involvement
• KS of the bowel and/or lungs is responsible
for numerous deaths

9. Pathogenesis
• Initially polyclonal proliferation is due
angiogenic factors.
• Later becomes monoclonal.
• KS lesions produce growth factors.
• It is not know how HHV8 promotes the
process.

10. Clinical manifestation
• Mucocutaneous lesions are usually
asymptomatic
• lower extremities - edema and moderate
to severe pain
• Urethral or anal canal lesions-
obstruction
• Pulmonary KS - bronchospasm,
intractable coughing, shortness of breath,
progressive respiratory failure.

11. Skin lesions
ecchymotic-
like macule
patches
papules,
plaques
nodules tumours
The lesions are normally palpable even at the
patch stage.

12. Classic ks

14. African KS

15. Oral kaposi sacroma

16. Investigations
• Skin biopsy- Vascular channels lined by
atypical endothelial cells.
- extravasated erythrocytes
with hemosiderin deposition
Imaging – abdominal ultrasound, cxr

17. Differential diagnosis
• Dermatofibroma
• melanocytic nevus
• ecchymosis
• granuloma annulare
• insect bite reactions

18. Management
• Radiotherapy
• Cryosurgery
• Photodynamic Therapy
• Excisional Surgery
• Intralesional Cytotoxic Chemotherapy
• Chemotherapy- single and combined
chemotherapy

19. If you’re not infected
you’re affected