Kaposi's sarcoma (Kaposi's angiosarcoma) is a multiple malignant tumors of the dermis (the dermis). The prevalence of the disease in general is low, however, Kaposi's sarcoma ranks first among cancers affecting HIV-infected patients, reaching figures of 40-60%. Among the factors provoking the development of Kaposi's sarcoma herpes virus usually referred 8-type (HHV-8, HHV-8). The groups at risk of developing Kaposi's sarcoma include the following:
HIV-infected men, particularly gay men
Older men of Mediterranean origin.
Individuals from equatorial Africa
Persons with organ transplant (recipient)
Usually, the tumor has a purple color, but color can be various shades of red, purple or brown. The tumor may be flat or slightly raised above the skin, is a painless spots or nodules. Almost always located in the skin, at least - to the internal organs. Kaposi's sarcoma is often associated with damage to the mucosa of the sky, the lymph nodes. The disease is slow. Detection of Kaposi's sarcoma in HIV infection provides the basis for the diagnosis of AIDS.
The histological structure of tumors characterized by many randomly distributed thin-walled beams of newly formed blood vessels and spindle-shaped cells. Characterized by infiltration of the tumor by lymphocytes and macrophages. The vascular nature of the tumor dramatically increases the risk of bleeding. However, to do a biopsy for suspected Kaposi's sarcoma is not necessary. Kaposi's sarcoma - a special type of tumor, which often requires not only verification of the diagnosis, but also its treatment. It may seem odd at first glance. This situation stems from the fact that the diagnosis can deliver error-free or without biopsy, and isolated treatment of Kaposi's sarcoma rarely makes a full recovery. Moreover, treatment of Kaposi's sarcoma (by virtue of its connection with the causal factors underlying disease) is usually palliative, ie directed only at reducing the symptoms of the disease.
It is believed that Kaposi's sarcoma in the early stages of the disease has symptoms of benign tumor: a weak mitotic activity, features of S-phase, this lack of invasive growth. The most aggressive course of Kaposi's sarcoma seen in AIDS patients, which distinguishes it from the classical variant of the disease. It is believed that Kaposi's sarcoma is a malignant neoplasm as an opportunist in immunocompromised patients. In other words, the normalization of the immune status of the body often contributes to tumor regression. That is why the isolated treatment of Kaposi's sarcoma conducted only in those cases when you need to neutralize its adverse symptoms - pain, swelling, and also to achieve an appropriate cosmetic effect.
Treatment of Kaposi's sarcoma may be local or systemic. Local therapy includes radiation techniques, cryotherapy, injection into the tumor chemotherapeutic agents, application of dinitrochlorobenzene, injections of interferon alpha in the tumor and some other methods. The main indications for irradiation are large or painful lesions, as well as an attempt to achieve a cosmetic effect. Sometimes the treatment of Kaposi's sarcoma may be associated with ulceration of tissue that is very dangerous because of the possibility of infection on a background of immunodeficiency.
Systemic treatment of Kaposi's sarcoma is possible in the presence of an immunologically favorable factors (eg, a large number of CD4 cells) in the presence of asymptomatic disease course. In this case, increasing the chances of cure. However, patients with poor prognosis of the disease may also be considered as candidates for treatment. In this case, a systemic chemotherapy or palliative monochemotherapy. The risk of chemotherapy in immunodeficiency associated with a toxic effect of chemotherapy on bone marrow, especially given the drugs used to treat HIV infection.
Manifestations of Kaposi's sarcoma may be unstable and even reversible, especially if the immune status of patients is relatively high, for example, if the number of CD-4 cells in 400 ml. This proves once again that the Kaposi's sarcoma is more stringent treatment of the underlying disease in order to improve the immune status, rather than the isolated treatment of manifestations of immune deficiency such as Kaposi's angiosarcoma.
