AIM: The aim of this case report is to present the case of a patient with iatrogenic Kaposi's sarcoma afflicting several organs, ocular manifestation. CASE REPORT: In a 74-year-old kidney transplant patient receiving immunosuppressive therapy, iatrogenic Kaposi's sarcoma (KS) developed in both lower eyelids. Subsequently, KS was confirmed in the region of the left forearm, with suspicion of lesions in the lungs. The ocular tumor was surgically removed with negative margins, requiring no further therapy. The lesion on the left forearm was completely excised. The patient underwent radiotherapy for the lung lesions, and immunosuppressive therapy was reduced. CONCLUSION: The case highlights the importance of early identification of KS, its histological verification, radical resection, and multidisciplinary collaboration. Knowledge of the epidemiology of this condition is a key factor in determining the correct diagnosis.
- Klíčová slova
- immunosuppression, Kaposi’s sarcoma, immunosuppression, multidisciplinary approach, multidisciplinary collaboration, radical resection,
- MeSH
- iatrogenní nemoci MeSH
- imunosupresivní léčba škodlivé účinky MeSH
- Kaposiho sarkom * diagnóza etiologie patologie MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Epstein-Barr virus (EBV) and Kaposi sarcoma-associated herpesvirus (KSHV) are cancer-causing viruses that belong to human gamma-herpesviruses. They are DNA viruses known to establish lifelong infections in humans, with the ability to develop various types of cancer. Drug resistance remains the main barrier to achieving effective therapies for viral infections and cancer. Thus, new medications with dual antiviral and anticancer actions are highly needed. Flavonoids are secondary metabolites biosynthesized by plants with diverse therapeutic effects on human health. In this review, we feature the potential role of flavonoids (flavones, protoflavones, isoflavones, flavanones, flavonols, dihydroflavonols, catechins, chalcones, anthocyanins, and other flavonoid-type compounds) in controlling gamma-herpesvirus-associated cancers by blocking EBV and KSHV infections and inhibiting the formation and growth of the correlated tumors, such as nasopharyngeal carcinoma, Burkitt's lymphoma, gastric cancer, extranodal NK/T-cell lymphoma, squamous cell carcinoma, Kaposi sarcoma, and primary effusion lymphoma. The underlying mechanisms via targeting EBV and KSHV life cycles and carcinogenesis are highlighted. Moreover, the effective concentrations or doses are emphasized.
- Klíčová slova
- Epstein–Barr virus (EBV), Kaposi sarcoma-associated herpesvirus (KSHV), anticancer properties, antiviral activities, cancer treatment, carcinogenesis, flavonoids, herpesviruses, molecular mechanisms, tumor viruses,
- MeSH
- anthokyaniny MeSH
- flavonoidy farmakologie terapeutické užití MeSH
- Herpesviridae * MeSH
- infekce virem Epsteina-Barrové * farmakoterapie MeSH
- Kaposiho sarkom * patologie MeSH
- karcinogeneze MeSH
- lidé MeSH
- lidský herpesvirus 8 * genetika MeSH
- nádory * farmakoterapie MeSH
- virus Epsteinův-Barrové genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- anthokyaniny MeSH
- flavonoidy MeSH
Primary effusion lymphoma (PEL) is a rare form of aggressive B-cell lymphoma characterized by a malignant serous effusion involving body cavities. It usually associated with human herpes virus-8 (HHV-8) and coexpression of Epstein-Barr virus and mostly affects patients with HIV. We report a rare case of cutaneous PEL with an unusual intravascular presentation, combined with Kaposi sarcoma involving the skin, lung, and gastrointestinal tract. The molecular genetic analysis of the sarcoma and lymphoma components, using next-generation sequencing was performed. The patient was a 67-year-old man who presented with multiple cutaneous tumors and mass in the left lung. He died 17 hours after the admission to the hospital. At autopsy, in addition to the cutaneous lesions, tumors in the left lung and gastrointestinal mucosa were detected, and no effusions in the body cavities were seen. The biopsy from the cutaneous lesions, pulmonary, and intestinal tumors revealed histological and immunohistochemical features of Kaposi sarcoma. In addition, the skin biopsy specimens contained a diffuse infiltrate composed of large pleomorphic cells, with focal intravascular growth that were negative for pan B-cell markers, weakly positive for CD38 and CD138 but expressed CD3, HHV-8, and Epstein-Barr virus. Molecular genetic studies in this specimen revealed monoclonal rearrangements of the IgH gene. The diagnosis of PEL, solid variant, was made. Next-generation sequencing analysis of the tumorous and normal tissue detected a pathogenic germline mutation of the FAM175A gene and somatic mutations in BRCA2 and RAD51B (in both sarcoma and lymphoma specimens), and INPP4B and RICTOR (in lymphoma specimen only).
- MeSH
- Kaposiho sarkom komplikace genetika patologie MeSH
- lidé MeSH
- primární efuzivní lymfom komplikace genetika patologie MeSH
- senioři MeSH
- transportní proteiny genetika MeSH
- zárodečné mutace MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- ABRAXAS1 protein, human MeSH Prohlížeč
- transportní proteiny MeSH
Kaposi's sarcoma (KS) is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments-imiquimod or topical 9-cis-retinoid acid-can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD) and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR) inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease.
- Klíčová slova
- EADO, EDF, EORTC, Guideline, Kaposi, Sarcoma,
- MeSH
- Kaposiho sarkom diagnóza patologie terapie MeSH
- konsensus MeSH
- lidé MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- Kaposiho sarkom diagnóza patologie MeSH
- lidé MeSH
- nádory kůže diagnóza patologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Kaposi's sarcoma was one of the very first diseases which indicated the advent of the AIDS pandemic. Despite the marked fall in its occurrence thanks to the introduction of the cART, Kaposi's sarcoma remains the most frequent tumour in HIV-positive patients and still represents a major diagnostic and therapeutic problem. Particularly in the early stages both the macroscopic and histopathological picture of Kaposi's sarcoma may be very atypical, which can cause diagnostic difficulties right at the time when an early therapy may be most successful. In order to improve both the diagnostics and therapy of Kaposi's sarcoma, close collaboration between physicians taking care of HIV-positive patients--mainly infectologists, dermatologists and pathologists, is necessary.
- MeSH
- dospělí MeSH
- HIV infekce komplikace MeSH
- Kaposiho sarkom komplikace diagnóza patologie terapie MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
- MeSH
- dospělí MeSH
- hemangioendoteliom chemie patologie MeSH
- imunohistochemie MeSH
- Kaposiho sarkom patologie MeSH
- lidé MeSH
- nádory kůže chemie patologie MeSH
- zevní ucho MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
A rare case of kaposiform hemangioendothelioma in adult is reported. The 11 x 7 x 5 cm tumor was excised from deep subcutis of the abdominal region in 37-year-old man. No signs of Kasabach-Merritt syndrome or lymphangiomatosis were present. Besides typical pattern of kaposiform hemangioendothelioma, following unusual features were found: dilated vessels producing a gross impression of spindle cell hemangioma, areas of amianthoid-like fibrosis, and diffuse immunoreactivity for CD99. The differential diagnosis included mainly spindle cell hemangioma (hemangioendothelioma), hemangiopericytoma-like solitary fibrous tumor, and Kaposi's sarcoma.
- MeSH
- dospělí MeSH
- fibróza MeSH
- hemangioendoteliom chemie patologie MeSH
- imunohistochemie MeSH
- Kaposiho sarkom chemie patologie MeSH
- lidé MeSH
- nádory kůže chemie patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
A peculiar vascular tumor of the pericardial cavity affecting a 21-year-old man is reported. The tumor was formed by spindle cells and narrow vascular channels. It was difficult to decide between primary pericardial Kaposi's sarcoma or angiosarcoma. The patient was HIV negative and no other tumors were revealed in the course of the disease. Immunohistochemical investigations showed positive endothelial markers-FVIII, CD 31, CD 34 in the tumor cells. Due to an inconclusive diagnosis of the tumor six cases of Kaposi's sarcoma and six cases of angiosarcomas were retrieved from our files, the same spectrum of immunohistochemistry as in above case applied, and the results compared. We found no significant differences in the positivity of endothelial markers among these cases and when compared with the case of pericardial tumor. The reactivity of CD 34 was, however, strong in cases of Kaposi's sarcoma whereas in angiosarcomas it yielded a weak and focal reaction only. In spite of the latter finding we feel that in individual cases, like the described tumor of the pericardial cavity, the immunohistochemical investigation cannot discriminate angiosarcoma from Kaposi's sarcoma. The reported tumor of the pericardial cavity was considered an unusual form of a low grade angiosarcoma with immunophenotypic features of Kaposi's sarcoma.
- MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- hemangiosarkom diagnóza patologie MeSH
- Kaposiho sarkom diagnóza patologie MeSH
- lidé MeSH
- nádory srdce diagnóza patologie MeSH
- perikard * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
We are observing a patient who is HIV positive since 1987 and in 1992 he got sick of AIDS. The first ophthalmologist symptom of the illness was a blurred disc margin of the optic nervehead with minor peripapillary hemorrhages and reduction of his visual acuity. After two months the condition of the fundus has improved but on the eyelash in the nasal half a Kaposi sarcoma is emerging. After six month of being sick of AIDS we are observing a reduction of visual acuity on the left eye and we diagnosed a Cytomegalic viral retinitis which is also confirmed serologically. Inspite of the treatment by Gancyclovir his condition is not improving and minor hemorrhages as well as microaneurysms are emerging also in macular area of the right eye.
- MeSH
- AIDS komplikace MeSH
- cytomegalovirová retinitida komplikace patologie MeSH
- Kaposiho sarkom etiologie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory očního víčka etiologie patologie MeSH
- oční nemoci komplikace MeSH
- oportunní infekce doprovázející AIDS MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
