经典型Kaposi肉瘤1例

报告1例经典型Kaposi肉瘤。患者男,37岁。双手足反复出现结节伴肿胀6年,脓疱2个月。皮损组织病理示:真皮及皮下组织内散在分布肿瘤细胞团块,主要由血管内皮样细胞组成,伴管腔形成;部分区域肿瘤细胞呈梭形,可见红细胞外溢及含铁血黄素沉积,散在少量单一核细胞浸润。诊断:Kaposi肉瘤。     

Mali型假性Kaposi肉瘤并发淤积性皮炎

报告1例Mali型假性Kaposi肉瘤并发淤积性皮炎。患者男,23岁。左小腿紫褐色丘疹及斑块1年余,伴肿胀、溃疡及疼痛2个月,伤口难以愈合。双下肢静脉曲张3年。皮肤科检查:皮损沿静脉曲张部分布,其上覆疣状增生性斑块,皮损周围见散在深褐色瘀斑,足、趾背无损害。皮损组织病理符合假性Kaposi肉瘤。免疫病理:血管内皮细胞CD34强阳性表达,周围间质细胞CD34阴性。诊断为Mali型假性Kaposi肉瘤并发淤积性皮炎。     

HIV相关型Kaposi肉瘤4例分析

目的:探讨HIV相关型Kaposi肉瘤的临床特点。方法:回顾性分析4例资料完整的HIV并发Kaposi肉瘤临床资料。结果:患者均为汉族人,皮损累及面部及口腔的3例,伴有双上肢皮损1例,肛周出现皮损1例。胸部CT均有微结节或弥漫性结节及毛玻璃影。皮损组织病理均诊断为Kaposi肉瘤,免疫组化结果:CD31(+),CD34(+),Ⅷ因子(+)3例,人疱疹病毒(HHV)-8(+)2例。CD4~+细胞数均低于1.2×10~8/L,平均0.495×10~8/L,HIV RNA均高于2.0×10~(10)拷贝/L,平均为5.77×10~(11)拷贝/L。结论:HIV相关型Kaposi肉瘤在汉族人中发病率极低,该病的发生有可能与CD4~+细胞数极低和病毒载量较高有关系。     

小剂量重组α干扰素治疗经典的Kaposi肉瘤

大剂量α干扰素(>2000万U/日)对部分AIDS相关的Kaposi肉瘤有效,特别是对免疫功能还相对保留者。而小剂量则无效。本文作者曾用小剂量重组α干扰素治疗淋巴瘤时,发现2例伴淋巴瘤相关的Kaposi肉瘤患者的Kaposi肉瘤得到消退。后又用同样方法治疗2例经典的Kaposi肉瘤取得同样疗效,一并报告于后:2例淋巴瘤患者,1例为73岁女性大细胞性淋巴瘤,确诊为淋巴瘤后16个月,在下腹部、左大腿     

新疆经典型Kaposi肉瘤38例临床及实验研究

目的 对1983—2003年新疆地区发现的38例Kaposi肉瘤进行临床报告，描述其临床表现、组织病理学改变以及超微结构特点等，进一步探讨新疆经典型Kaposi肉瘤的临床基病理诊断要点，Kaposi肉瘤的组织发生以及HIV—8在其发生发展中的作用。方法 对确诊住院的38例Kaposi肉瘤病例资料进行回顾性研究，对部分Kaposi肉瘤组织进行光镜和电镜观察。应用PCR和荧光原位PCR方法，对部分患者血和病理组织进行HHV—8的检测。结果 38例新疆经典型Kaposi肉瘤主要发生在新疆地区的维吾尔族和哈萨克族。血清HIV抗体检测均为阴性，内脏损害少，以皮肤损害为主，皮损主要发生在四肢末端，基本损害为斑片、斑块和结节。组织病理改变以梭型细胞和小血管增生为主，伴有红细胞外溢及含铁血黄素沉积，随皮损形态不同病理学改变有差异。电镜观察Kaposi肉瘤组织除含有分化不等的瘤血管外，肿瘤细胞大致分明、暗两大类，明细胞可能为内皮细胞起源，暗细胞可能起源于周细胞。HHV—8血阳性率为70％，组织阳性率85％。结论 新疆Kaposi肉瘤的临床表现类似于经典型，但又有一定的特点，其病理改变，随皮损的临床表现不同而有一定差异，超微结构表现支持Kaposi肉瘤起源于血管内皮细胞和周细胞的观点。HHV—8感染在新疆Kaposi肉瘤的发病机制中有重要的作用。     

艾滋病相关型Kaposi肉瘤1例

患者男,34岁。面部多发紫蓝色皮疹2个月余。皮损组织病理检查示:Kaposi肉瘤;抗HIV抗体(+)。诊断:艾滋病相关型Kaposi肉瘤。     

老年经典型Kaposi肉瘤1例

患者女,88岁,汉族,左下肢紫红色斑块、结节1年。皮损组织病理示:真皮内胶原增生,可见多数血管增生,伴血栓形成,部分区域可见内皮细胞增生。免疫组织化学示:CD31(+)、CD34(+)、HHV-8(+)、D2-40(+)。诊断:经典型Kaposi肉瘤。     

误诊为疖的艾滋病相关Kaposi肉瘤1例

患者男,40岁,汉族。下颌部红褐色结节2个月,无特殊自觉症状。外院曾诊断为"疖"欲行切开引流;门诊拟诊"下颌结节待查,不除外Kaposi肉瘤"。皮损组织病理示:表皮大致正常,真皮内大量的梭形细胞增生,其间呈血管样裂隙,裂隙内可见红细胞;免疫组化标记CD31(+),CD34(+)。诊断:Kaposi肉瘤。     

朗格汉斯细胞肉瘤

报告1例朗格汉斯细胞肉瘤。患者男,78岁。躯干、四肢红色丘疹、斑块7个月。皮疹渐增大,增多,部分融合,伴明显瘙痒。皮损组织病理检查示:表皮内及真皮浅层可见较多上皮样细胞增生,胞质丰富呈嗜酸性,细胞核大、深染,核仁明显,有明显的异形性和异常核分裂象。免疫组化结果显示肿瘤细胞S-100蛋白、CD1a和CD207阳性,CD68阴性。结合临床、组织病理及免疫组化结果诊断为朗格汉斯细胞肉瘤。     

皮肤恶性淋巴瘤和Kaposl肉瘤患者的聚胺含量

目前研究证实,肿瘤细胞中聚胺合成的速度和在组织、器官中积聚增多与肿瘤的进展直接相关,腐胺水平可反映肿瘤细胞增殖强度,尿中精胺和精脒的含量在很大程度上也说明肿瘤细胞崩解的强度。作者以聚胺作为皮肤淋巴增殖性疾病和Ka—posi肉瘤的标志进行研究。选择39例皮肤淋巴增殖性疾病和Kaposi肉瘤患者,年龄15～76岁,病程4月～3年,其中蕈样肉芽肿(MF)24例,皮肤网状细胞增多症(现称皮肤B细胞淋巴瘤CBCL,校者注)10例和Kaposi肉瘤5例。应用改良的高     

基于网络药理学预测中药在抗卡波西肉瘤血管生成治疗中的潜在有效成分及分子作用机制

【摘要】 目的 基于网络药理学方法分析中药抗卡波西肉瘤血管生成的潜在有效成分及分子作用机制，预测中药在抗卡波西肉瘤血管生成中的关键靶点和信号通路。方法 根据既往网络药理学研究结果，利用中药系统药理学数据库与分析平台（TCMSP）获取虎杖、桑白皮、土茯苓、紫苏子的主要化学成分和靶点；通过GeneCard、OMIM、DrugBank、TTD数据库检索获取血管生成及卡波西肉瘤治疗靶点，构建韦恩图，得到卡波西肉瘤与抗血管生成药物成分相互作用的靶点；利用STRING 11.5平台构建蛋白质互作模型；应用Cytoscape3.6.0软件构建成分-靶点网络，并进行可视化。同时利用Metascape平台对核心靶点进行基因本体（GO）功能富集分析和京都基因与基因组百科全书（KEGG）通路富集分析。最后将得到的主要活性成分和核心靶点进行分子对接验证。结果 抗卡波西肉瘤血管生成药物的核心成分为白藜芦醇［连接度（degree）142］、槲皮素（degree：141）、山柰酚（degree：56）、木樨草素（degree：56）、β-谷甾醇（degree：37）、花生四烯酸（degree：36）、柚皮素（degree：36）等，核心靶点是前列腺素内过氧化物合酶2（PTGS2）。利用KEGG分析筛选出抗卡波西肉瘤血管生成相关的重要通路为癌症信号通路；GO分析显示在生物学过程中靶点主要集中在细胞迁移的正调控。分子对接结果显示白藜芦醇、槲皮素、山柰酚和木樨草素与PTGS2均有较好的亲和力，其中槲皮素和木樨草素与PTGS2结合能力最高，结合能分别为-9.4、-9.5 kcal/mol。结论 本研究表明中医药百科全书数据库所录入的4种中药可能通过调控癌症信号通路，作用于PTGS2等靶点发挥抗血管生成作用，从而预测了中药抗卡波西肉瘤血管生成的可能作用机制。     

艾滋病相关型卡波西肉瘤1例

报告以左手背暗红色半球状结节为表现的艾滋病相关型卡波西（Kaposi）肉瘤1例。患者男,31岁。发热、双侧耳后肿痛18天,入院前10天左手背出现暗红色圆形结节,渐增大为2个半球状结节。抗HIV抗体（＋）。皮肤组织病理检查示：Kaposi’s肉瘤。诊断：艾滋病相关型卡波西肉瘤。拉米夫定（3TC）、司他夫定（D4T）、克力芝（洛匹那韦／利托那韦）抗病毒治疗3个月后,皮损逐渐消退。     

中国大陆免疫抑制剂相关型Kaposi肉瘤(1995—2020年)回顾性分析

 目的:了解中国大陆地区近25年免疫抑制剂相关型Kaposi肉瘤的临床特征和诊治现状。方法:通过中国知网、万方、维普和Pubmed检索1995—2020年中国大陆地区免疫抑制剂相关型Kaposi肉瘤相关文献,进行数据分析和总结。结果:共纳入文献40篇,共计42例患者。患者平均年龄47.4岁;男女患病比例3.67 ∶1;多发生在肾移植术后使用一种或多种免疫抑制剂/糖皮质激素;于用药后2～3个月或1～2年发病。较多累及全身皮肤,其中下肢多见,也可累及内脏器官或淋巴结。治疗以减少或停用或更换免疫抑制剂/糖皮质激素为主,必要时可联合其他治疗方案。结论:在临床上长期使用免疫抑制剂或激素后应警惕Kaposi肉瘤的发生,减少或停用或更换免疫抑制剂/糖皮质激素后多预后良好。     

Disseminated Kaposi sarcoma with epithelioid morphology in an HIV/AIDS patient: A previously unreported variant

Kaposi sarcoma is an oligoclonal HHV‐8‐driven vascular proliferation that was first described by a Viennese dermatologist Dr Moritz Kaposi. The disease has been seen in different clinical‐epidemiological settings with a wide morphologic spectrum. We report a 52‐year‐old Caucasian man with HIV/AIDS and Kaposi sarcoma who presented with dyspnea and pleural effusion. He reported numerous tender subcutaneous nodules developing over the past few months on his chest, back and abdomen. An excisional biopsy of one of the nodules was performed. Touch preps revealed malignant cells in clusters. Microscopically, the neoplasm appeared undifferentiated with an epithelioid morphology, and involved the dermis and subcutaneous fat. Despite the medical history, Kaposi sarcoma was not considered foremost in the differential diagnosis. The malignant cells were positive for vimentin and negative for S100 protein, keratin AE1/3, CK7, CK20, napsin A, TTF‐1 and synaptophysin. Additional stains revealed positivity for HHV‐8, CD31 and D2‐40, supporting the diagnosis of Kaposi sarcoma. Kaposi sarcoma has been well described with many variants that may cause diagnostic difficulty. An epithelioid variant has not been reported and consequently, may cause misinterpretation of an otherwise well‐known entity that may become life threatening if appropriate treatment is not initiated in a timely manner.     

Indurated vascular plaques on the legs of an 85-year-old woman

This is a case of classic type Kaposi sarcoma occurring in an 85-year-old woman who presented with indurated vascular plaques on both legs below the knee that has been present for two years. A brief review of the literature on Kaposi sarcoma is included.     

ErbB1,ErbB3在新疆经典型Kaposi肉瘤中的表达及意义

目的探讨表皮生长因子受体1(ErbB1)与ErbB3基因在新疆经典型Kaposi肉瘤(kaposi′s sarcoma,KS)发病过程中的表达情况。方法分别采用实时荧光定量PCR和免疫组化技术,对17例新疆经典型KS患者的肿瘤组织和瘤旁正常组织中ErbB1与ErbB3基因的表达进行检测。结果 ErbB1,ErbB3基因在KS肿瘤组织中mRNA的表达均低于瘤旁正常组织中的表达,差异有统计学意义(P0.05);在KS与KS瘤旁正常组织中,ErbB1蛋白阳性表达率分别为11.8%和94.1%;ErbB3蛋白阳性表达率分别为17.6%和94.1%,ErbB1,ErbB3蛋白在KS中的表达明显低于在KS瘤旁正常组织中的表达,差异均有统计学意义(P0.005)。结论 ErbB1和ErbB3基因在KS组织中呈现低度表达或不表达,提示其在新疆经典型KS肿瘤细胞增殖中可能作用有限。     

Radiotherapy in the management of classic Kaposi's sarcoma: A single institution experience from Northeast Turkey

Kaposi sarcoma is a rare adult neoplasm and there has been no certain consensus on standard treatment, either local or systemic. Radiotherapy is an effective, suitable treatment modality. Between 1996 and 2016, patients who were diagnosed with Kaposi sarcoma and referred to our clinic for radiotherapy were included in this retrospective study. Ninety‐two patients were examined in total and it was diagnosed that all the patients had non‐HIV associated Kaposi's sarcoma. There were 36 (39%) females and 56 (61%) males and female to male ratio was 2/3. Median age at presentation was 72 (30–93) years. Sixty‐eight patients (77%) were treated with 8 Gy (1 fraction), 15 patients (16%) were treated with 20 Gy (2 Gy/fraction), four patients (4%) were treated 25 Gy (2.5 Gy/fraction), and five patients (6%) were treated 30 Gy (3 Gy/fraction). The median follow‐up time was 72 (5–192) months. The complete response at 5 years was 91.6% with >20 Gy and 89.6% with 8 Gy. Radiotherapy is an effective, suitable treatment modality of Classic Kaposi sarcoma and usually, radiotherapy is well tolerated with minimal side effects.     

Granulocyte colony stimulating factor (G-CSF) in treatment of patients with HIV-associated mucocutaneous Kaposi sarcoma. Successful use in virus and drug-induced leukopenia]

Three patients with HIV-associated Kaposi sarcoma were treated with human recombinant granulocyte colony stimulating factor (G-CSF). They had all developed leucopenia during treatment with recombinant interferon-alpha-2a, in two cases combined with vincristine. In all three patients, there was an obvious rapid stimulation after s.c. injection of 300 or 150 micrograms G-CSF per day; the white blood count reached normal values within only a few days and partial transformation to leucocytosis took place. After discontinuation of G-CSF, leucocyte counts regressed rapidly to pretreatment levels. A dose of 150 micrograms of G-CSF twice to three times per week proved to be sufficient to keep the white blood cell count in the normal range allowing the treatment necessary for Kaposi sarcoma. G-CSF therapy had no serious side effects. One of the patients developed a tumour-like infiltration in his left upper jaw, which histologically simulated Burkitt's lymphoma and which regressed spontaneously after discontinuation of the G-CSF therapy. G-CSF plays an important role in the treatment of patients with HIV-associated Kaposi sarcoma and enables combined treatment with zidovudine, interferon, and cytostatic drugs.     

Acroangiodermatitis (pseudo-Kaposi sarcoma): three case reports

Acroangiodermatitis (synonym pseudo-Kaposi sarcoma) is a dermatological condition characterized by purple-colored nodules, plaques or patches, mostly on the extensor surfaces of lower extremities, usually in patients with chronic venous insufficiency and arteriovenous malformations of the legs, but also in hemodialysis patients with iatrogenic arteriovenous shunts, paralyzed limbs and amputation stumps. Acroangiodermatitis in patients with chronic venous insufficiency manifests usually as bilateral skin lesions located on the dorsa of the feet, halux and second toe, or on the medial aspect of lower legs. Acroangiodermatitis may look like Kaposi sarcoma, but in contrast to Kaposi sarcoma, acroangiodermatitis is not characterized by progression of changes, and there is a lack of spindle cells and silt-like vessels on histopathologic analysis. Three cases of acroangiodermatitis encountered in our clinical practice are described. The patients presented with livid-erythematous patches on lower legs and skin changes connected with chronic venous insufficiency, treated at the Department Phlebology Unit. Results of the histopathologic analysis indicated acroangiodermatitis. Thus, in clinical practice it is important to recognize acroangiodermatitis and to exclude Kaposi sarcoma, as sometimes there is similarity with this entity. Topical therapy with neutral and local corticosteroid preparations is often useful, however, the use of compressive bandages and dermatologic follow up are recommended.     

艾滋病相关型Kaposi肉瘤1例

患者男,33岁。头颈部、胸背、双上肢皮肤及口腔黏膜紫红色结节及斑块2月余。患者系男同性恋,有高危性接触史。实验室检查示HIV初筛及确认试验均为阳性,CD4细胞计数18个/μL,皮肤组织病理符合Kaposi肉瘤。