Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology
Identifieur interne : 001D16 ( Pmc/Curation ); précédent : 001D15; suivant : 001D17Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology
Auteurs : Taisa Davaus Gasparetto [Brésil] ; Edson Marchiori [Brésil] ; Sílvia Lourenço [Brésil] ; Gláucia Zanetti [Brésil] ; Alberto Domingues Vianna [Brésil] ; Alair Asmd Santos [Brésil] ; Luiz Felipe Nobre [Brésil]Source :
- Orphanet Journal of Rare Diseases [ 1750-1172 ] ; 2009.
Abstract
Kaposi sarcoma is a low-grade mesenchymal tumor involving blood and lymphatic vessels. There are four variants of this disease, each presenting a different clinical manifestation: classic or sporadic, African or endemic, organ transplant-related or iatrogenic, and AIDS-related or epidemic. Kaposi sarcoma is the most common tumor among patients with HIV infection, occurring predominantly in homosexual or bisexual men. The pulmonary involvement in Kaposi sarcoma occurs commonly in critically immunosupressed patients who commonly have had preceding mucocutaneous or digestive involvement.
The etiology of Kaposi sarcoma is not precisely established; genetic, hormonal, and immune factors, as well as infectious agents, have all been implicated. There is evidence from epidemiologic, serologic, and molecular studies that Kaposi sarcoma is associated with human herpes virus type 8 infection. The disease starts as a reactive polyclonal angioproliferative response towards this virus, in which polyclonal cells change to form oligoclonal cell populations that expand and undergo malignant transformation.
The diagnosis of pulmonary involvement in Kaposi sarcoma usually can be made by a combination of clinical, radiographic, and laboratory findings, together with the results of bronchoscopy and transbronchial biopsy. Chest high-resolution computed tomography scans commonly reveal peribronchovascular and interlobular septal thickening, bilateral and symmetric ill-defined nodules in a peribronchovascular distribution, fissural nodularity, mediastinal adenopathies, and pleural effusions. Correlation between the high-resolution computed tomography findings and the pathology revealed by histopathological analysis demonstrate that the areas of central peribronchovascular infiltration represent tumor growth involving the bronchovascular bundles, with nodules corresponding to proliferations of neoplastic cells into the pulmonary parenchyma. The interlobular septal thickening may represent edema or tumor infiltration, and areas of ground-glass attenuation correspond to edema and the filling of air spaces with blood. These findings are a result of the propensity of Kaposi sarcoma to grow in the peribronchial and perivascular axial interstitial spaces, often as continuous sheets of tumor tissue.
In conclusion, radiological findings can play a major role in the diagnosis of pulmonary Kaposi sarcoma since characteristic patterns may be observed. The presence of these patterns in patients with AIDS is highly suggestive of Kaposi sarcoma.
Url:
DOI: 10.1186/1750-1172-4-18
PubMed: 19602252
PubMed Central: 2720383
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<front><div type="abstract" xml:lang="en"><p>Kaposi sarcoma is a low-grade mesenchymal tumor involving blood and lymphatic vessels. There are four variants of this disease, each presenting a different clinical manifestation: classic or sporadic, African or endemic, organ transplant-related or iatrogenic, and AIDS-related or epidemic. Kaposi sarcoma is the most common tumor among patients with HIV infection, occurring predominantly in homosexual or bisexual men. The pulmonary involvement in Kaposi sarcoma occurs commonly in critically immunosupressed patients who commonly have had preceding mucocutaneous or digestive involvement.</p>
<p>The etiology of Kaposi sarcoma is not precisely established; genetic, hormonal, and immune factors, as well as infectious agents, have all been implicated. There is evidence from epidemiologic, serologic, and molecular studies that Kaposi sarcoma is associated with human herpes virus type 8 infection. The disease starts as a reactive polyclonal angioproliferative response towards this virus, in which polyclonal cells change to form oligoclonal cell populations that expand and undergo malignant transformation.</p>
<p>The diagnosis of pulmonary involvement in Kaposi sarcoma usually can be made by a combination of clinical, radiographic, and laboratory findings, together with the results of bronchoscopy and transbronchial biopsy. Chest high-resolution computed tomography scans commonly reveal peribronchovascular and interlobular septal thickening, bilateral and symmetric ill-defined nodules in a peribronchovascular distribution, fissural nodularity, mediastinal adenopathies, and pleural effusions. Correlation between the high-resolution computed tomography findings and the pathology revealed by histopathological analysis demonstrate that the areas of central peribronchovascular infiltration represent tumor growth involving the bronchovascular bundles, with nodules corresponding to proliferations of neoplastic cells into the pulmonary parenchyma. The interlobular septal thickening may represent edema or tumor infiltration, and areas of ground-glass attenuation correspond to edema and the filling of air spaces with blood. These findings are a result of the propensity of Kaposi sarcoma to grow in the peribronchial and perivascular axial interstitial spaces, often as continuous sheets of tumor tissue.</p>
<p>In conclusion, radiological findings can play a major role in the diagnosis of pulmonary Kaposi sarcoma since characteristic patterns may be observed. The presence of these patterns in patients with AIDS is highly suggestive of Kaposi sarcoma.</p>
</div>
</front>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Orphanet J Rare Dis</journal-id>
<journal-title>Orphanet Journal of Rare Diseases</journal-title>
<issn pub-type="epub">1750-1172</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19602252</article-id>
<article-id pub-id-type="pmc">2720383</article-id>
<article-id pub-id-type="publisher-id">1750-1172-4-18</article-id>
<article-id pub-id-type="doi">10.1186/1750-1172-4-18</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology</article-title>
</title-group>
<contrib-group><contrib id="A1" contrib-type="author"><name><surname>Gasparetto</surname>
<given-names>Taisa Davaus</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>taisadavaus@gmail.com</email>
</contrib>
<contrib id="A2" corresp="yes" contrib-type="author"><name><surname>Marchiori</surname>
<given-names>Edson</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>edmarchiori@gmail.com</email>
</contrib>
<contrib id="A3" contrib-type="author"><name><surname>Lourenço</surname>
<given-names>Sílvia</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>s.louren@terra.com.br</email>
</contrib>
<contrib id="A4" contrib-type="author"><name><surname>Zanetti</surname>
<given-names>Gláucia</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>glauciazanetti@gmail.com</email>
</contrib>
<contrib id="A5" contrib-type="author"><name><surname>Vianna</surname>
<given-names>Alberto Domingues</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>albertodvianna@terra.com.br</email>
</contrib>
<contrib id="A6" contrib-type="author"><name><surname>Santos</surname>
<given-names>Alair ASMD</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>alairsarmet@globo.com</email>
</contrib>
<contrib id="A7" contrib-type="author"><name><surname>Nobre</surname>
<given-names>Luiz Felipe</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>luizfelipenobresc@gmail.com</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Department of Radiology, Fluminense Federal University, Rio de Janeiro, Brazil</aff>
<aff id="I2"><label>2</label>
Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil</aff>
<aff id="I3"><label>3</label>
Faculty of Medicine, Santa Catarina Federal University, Florianópolis, Brazil</aff>
<pub-date pub-type="collection"><year>2009</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>7</month>
<year>2009</year>
</pub-date>
<volume>4</volume>
<fpage>18</fpage>
<lpage>18</lpage>
<ext-link ext-link-type="uri" xlink:href="http://www.ojrd.com/content/4/1/18"></ext-link>
<history><date date-type="received"><day>3</day>
<month>2</month>
<year>2009</year>
</date>
<date date-type="accepted"><day>14</day>
<month>7</month>
<year>2009</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2009 Gasparetto et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2009</copyright-year>
<copyright-holder>Gasparetto et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0"></ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
<pmc-comment>
Gasparetto
Davaus
Taisa
taisadavaus@gmail.com
Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology
2009 Orphanet Journal of Rare Diseases 4(1): 18-. (2009) 1750-1172(2009)4:1<18> urn:ISSN:1750-1172 </pmc-comment>
</license>
</permissions>
<abstract><p>Kaposi sarcoma is a low-grade mesenchymal tumor involving blood and lymphatic vessels. There are four variants of this disease, each presenting a different clinical manifestation: classic or sporadic, African or endemic, organ transplant-related or iatrogenic, and AIDS-related or epidemic. Kaposi sarcoma is the most common tumor among patients with HIV infection, occurring predominantly in homosexual or bisexual men. The pulmonary involvement in Kaposi sarcoma occurs commonly in critically immunosupressed patients who commonly have had preceding mucocutaneous or digestive involvement.</p>
<p>The etiology of Kaposi sarcoma is not precisely established; genetic, hormonal, and immune factors, as well as infectious agents, have all been implicated. There is evidence from epidemiologic, serologic, and molecular studies that Kaposi sarcoma is associated with human herpes virus type 8 infection. The disease starts as a reactive polyclonal angioproliferative response towards this virus, in which polyclonal cells change to form oligoclonal cell populations that expand and undergo malignant transformation.</p>
<p>The diagnosis of pulmonary involvement in Kaposi sarcoma usually can be made by a combination of clinical, radiographic, and laboratory findings, together with the results of bronchoscopy and transbronchial biopsy. Chest high-resolution computed tomography scans commonly reveal peribronchovascular and interlobular septal thickening, bilateral and symmetric ill-defined nodules in a peribronchovascular distribution, fissural nodularity, mediastinal adenopathies, and pleural effusions. Correlation between the high-resolution computed tomography findings and the pathology revealed by histopathological analysis demonstrate that the areas of central peribronchovascular infiltration represent tumor growth involving the bronchovascular bundles, with nodules corresponding to proliferations of neoplastic cells into the pulmonary parenchyma. The interlobular septal thickening may represent edema or tumor infiltration, and areas of ground-glass attenuation correspond to edema and the filling of air spaces with blood. These findings are a result of the propensity of Kaposi sarcoma to grow in the peribronchial and perivascular axial interstitial spaces, often as continuous sheets of tumor tissue.</p>
<p>In conclusion, radiological findings can play a major role in the diagnosis of pulmonary Kaposi sarcoma since characteristic patterns may be observed. The presence of these patterns in patients with AIDS is highly suggestive of Kaposi sarcoma.</p>
</abstract>
</article-meta>
</front>
</pmc>
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