Clinical and histopathological aspects of Kaposi's sarcoma in Africa: relationship with HIV serology

Kaposi's sarcoma of the colon in a young HIV-negative woman with Crohn's disease

We report a case of isolated colonic Kaposi's sarcoma in a 36-year-old HIV-negative woman with refractory Crohn's disease of the colon and perineum following 11 months' treatment with azathioprine. The clinical features of this case are quite different from those classically described in Kaposi's sarcoma. Among the known risk factors, iatrogenic immunosuppression would appear to be the most probable.

Endemic and atypical Kaposi's sarcoma in Africa--histopathological aspects

Atypical HIV-associated and endemic Kaposi's sarcoma (KS) differ in their clinical presentation and behaviour. To assess the possible histological differences, a detailed review of 32 cases of atypical KS and 170 cases of endemic KS from sub-Saharan Africa was undertaken. Both forms of KS had similar histological appearances, and evolved through a chronological sequence of patch, plaque and nodule. There was an increase in the proportion of early patch and plaque lesions in cutaneous and mucosal atypical KS (54%) compared with endemic KS (23%). However, nodular lesions were still seen in atypical KS, and formed 56% of the total cases. In addition, atypical KS tended to have more small blood vessels and a lesser degree of inflammatory infiltrate. However, within each of the three stages of the disease, it was not possible to distinguish between the HIV- and non-HIV-related forms.