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Dupin N, Jary A, Boussouar S, Syrykh C, Gandjbakhche A, Bergeret S, Palich R. Current and Future Tools for Diagnosis of Kaposi's Sarcoma. Cancers (Basel) 2021; 13:cancers13235927. [PMID: 34885035 PMCID: PMC8657166 DOI: 10.3390/cancers13235927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Kaposi’s sarcoma, a rare opportunistic tumor, is observed in four epidemiological conditions (AIDS-related, iatrogenic, endemic or classic KS). Although in most cases KS is an indolent disease, it can be locally aggressive and/or it can invade other organs than the skin, resulting in more severe presentations, especially in patients with severe immunosuppression. There is no consensus on the imaging workup that is necessary for either the initial staging of the disease or the follow-up. Future perspectives include the use of certain non-invasive imaging tools that may help to evaluate the clinical response to treatment, as well as certain new histological markers that may help in guiding the treatment planning for this atypical neoplasm. Abstract Kaposi’s sarcoma (KS) is a rare, atypical malignancy associated with immunosuppression and can be qualified as an opportunistic tumor, which responds to immune modulation or restoration. Four different epidemiological forms have been individualized (AIDS-related, iatrogenic, endemic or classic KS). Although clinical examination is sufficient to diagnose cutaneous lesions of KS, additional explorations are necessary in order to detect lesions involving other organs. New histological markers have been developed in recent years concerning the detection of HHV-8 latent or lytic proteins in the lesions, helping to confirm the diagnosis when it is clinically doubtful. More recently, the evaluation of the local immune response has also been shown to provide some guidance in choosing the appropriate therapeutic option when necessary. We also review the indication and the results of conventional radiological imaging and of non-invasive imaging tools such as 18F-fluoro-deoxy-glucose positron emission tomography, thermography and laser Doppler imaging for the diagnosis of KS and for the follow-up of therapeutic response in patients requiring systemic treatment.
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Affiliation(s)
- Nicolas Dupin
- Dermatology Department, Cochin Hospital, AP-HP, Institut Cochin, INSERM 1016, Université de Paris, 75014 Paris, France;
| | - Aude Jary
- Virology Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Sorbonne University, 75013 Paris, France;
| | - Samia Boussouar
- Cardiothoracic Imaging Unit, Pitié-Salpêtrière Hospital, AP-HP, ICAN Institute of Cardiometabolism and Nutrition, INSERM, Sorbonne University, 75013 Paris, France;
| | - Charlotte Syrykh
- Department of Pathology, University Cancer Institute of Toulouse-Oncopole, 31000 Toulouse, France;
| | - Amir Gandjbakhche
- Section on Analytical and Functional Biophotonics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Sébastien Bergeret
- Nuclear Medicine Department, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, 75013 Paris, France;
| | - Romain Palich
- Infectious Diseases Department, Pitié-Salpêtrière Hospital, AP-HP, Pierre Louis Epidemiology and Public Health Institute (iPLESP), INSERM 1136, Sorbonne University, 75013 Paris, France
- Correspondence: ; Tel.: +33-1-42-16-01-71; Fax: +33-1-42-16-04-45
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Ahn JW, Shalabi D, Correa-Selm LM, Dasgeb B, Nikbakht N, Cha J. Impaired wound healing secondary to bevacizumab. Int Wound J 2019; 16:1009-1012. [PMID: 31111622 DOI: 10.1111/iwj.13139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/28/2019] [Indexed: 01/16/2023] Open
Abstract
Bevacizumab is a monoclonal antibody that exerts its antitumor activity by inhibiting vascular endothelial growth factor. Consequently, it suppresses endothelial cell proliferation, vascular permeability, and angiogenesis. This inhibitory effect contributes to tumour size reduction but causes wound-healing delay, specifically during the proliferative phase, in patients receiving bevacizumab. Although surgical wound-healing complications (WHC) associated with bevacizumab have been extensively reported, there is limited literature on peripheral WHC. More importantly, the histopathology of bevacizumab-associated WHC has not been described. We present the histopathology findings of a non-healing ulcer in a patient receiving bevacizumab, providing insight into the possible aetiology of this drug's adverse reaction. Furthermore, our patient's positive response to hyperbaric oxygen suggests its possible use for treatment of bevacizumab-associated non-healing wounds.
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Affiliation(s)
- Ji W Ahn
- Department of Dermatology, University of Michigan Hospitals, Ann Arbor, Michigan
| | - Doaa Shalabi
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lilia M Correa-Selm
- Scully Welsh Cancer Center, Cleveland Clinic Indian River Hospital, Vero Beach, Florida
| | - Bahar Dasgeb
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jisun Cha
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.,Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Dasgeb B, Morris MA, Mehregan D, Siegel EL. Quantified ultrasound elastography in the assessment of cutaneous carcinoma. Br J Radiol 2015; 88:20150344. [PMID: 26268142 DOI: 10.1259/bjr.20150344] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the feasibility of high-frequency ultrasound and ultrasound elastography (USE) in discriminating benign from malignant skin lesions in a prospective cohort study and to introduce the use of a "strain ratio" for evaluation of skin lesions. METHODS A commercial ultrasound system with a 14-MHz transducer was used to visualize skin lesions requiring biopsy on clinical evaluation. Anatomic ultrasound and USE imaging of the skin lesions was performed using 2- to 4-mm gel stand-off pads. A region of interest was manually selected over the area of each lesion with the lowest strain. The concept of a strain ratio of the compressibility of the normal skin at the corresponding layer to that of the least compressible region of a lesion in question was created and applied. This ratio was subsequently correlated with blind histopathological evaluation for malignancy. RESULTS 55 patients were included in the study with a total of 67 lesions evaluated. 29 lesions were malignant and 38 benign. All malignant lesions had strain ratios ≥3.9. All benign lesions had strain ratios ≤3.0. A diagnostic value between 3.0 and 3.9 would result in 100% sensitivity and specificity in the characterization of these lesions as malignant. CONCLUSION This pilot study demonstrated that USE plus strain ratio appears to be a promising modality in providing diagnostic determination between cancerous and benign primary solitary skin lesions prior to biopsy. ADVANCES IN KNOWLEDGE This is the first reported study applying an original mathematical elastographic ratio, or strain ratio, to evaluate primary solitary skin lesions.
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Affiliation(s)
- Bahar Dasgeb
- 1 Department of Medicine Dermatology Service, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY, USA.,2 Analytical and Stochastic Biomedical Physics Section, National Institutes of Health, Bethesda, MD, USA
| | - Michael A Morris
- 3 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA.,4 Department of Internal Medicine, Mercy Medical Center, Baltimore, MD, USA
| | - Darius Mehregan
- 5 Department of Dermatology, Wayne State University, Dearborn, MI, USA.,6 Pinkus Dermatopathology Laboratories, Monroe, MI, USA
| | - Eliot L Siegel
- 3 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, MD, USA.,7 Department of Diagnostic Radiology and Nuclear Medicine, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
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