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Guan CS, Yu J, Du YN, Zhou XG, Zhang ZX, Chen H, Xing YX, Xie RM, Lv ZB. Hepatic Involvement in Acquired Immunodeficiency Syndrome-Associated Kaposi's Sarcoma: A Descriptive Analysis on CT, MRI, and Ultrasound. Infect Drug Resist 2024; 17:1073-1084. [PMID: 38525478 PMCID: PMC10959242 DOI: 10.2147/idr.s440305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose To retrospectively analyse the different imaging manifestations of acquired immunodeficiency syndrome-associated hepatic Kaposi's sarcoma (AIDS-HKS) on CT, MRI, and Ultrasound. Patients and Methods Eight patients were enrolled in the study. Laboratory tests of liver function were performed. The CT, MRI, and Ultrasound manifestations were reviewed by two radiologists and two sonographers, respectively. The distribution and imaging signs of AIDS-HKS were evaluated. Results AIDS-HKS patients commonly presented multiple lesions, mainly distributed around the portal vein on CT, MRI, and Ultrasound. AIDS-HKS presented as ring enhancement in the arterial phase on contrast-enhanced CT and MRI scanning, and nodules gradually strengthen in the portal venous phase and the delayed phase. AIDS-HKS presented as intrahepatic bile duct dilatation and bile duct wall thickening around the lesion. Five patients (62.5%, 5/8) were followed up. After chemotherapy, the lesions were completely relieved (60.0%), or decreased (40.0%). Conclusion AIDS-HKS presented as multiple nodular lesions with different imaging features. The combination of different imaging methods was helpful for the imaging diagnosis of AIDS-HKS.
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Affiliation(s)
- Chun-Shuang Guan
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jing Yu
- Department of Ultrasonography, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yan-Ni Du
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xin-Gang Zhou
- Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zi-Xin Zhang
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Hui Chen
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yu-Xue Xing
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Ru-Ming Xie
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Zhi-Bin Lv
- Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
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Möller K, Ntovas S, Hocke M, On W, Everett SM, Braden B, Jenssen C, Misselwitz B, Ge N, Sun S, Gerber M, Faiss S, Dietrich CF. Comments and illustrations of the European Federation of Societies for Ultrasound in Medicine guidelines: Rare pancreatic tumors, ultrasound and contrast-enhanced ultrasound features-Malignant mesenchymal tumors. Endosc Ultrasound 2024; 13:55-64. [PMID: 38947746 PMCID: PMC11213603 DOI: 10.1097/eus.0000000000000054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Rare malignant mesenchymal pancreatic tumors are systematized and reported in this review. The focus is on the appearance on imaging. The present overview summarizes the data and shows that not every pancreatic tumor corresponds to the most common entities of ductal adenocarcinoma or neuroendocrine tumor.
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Affiliation(s)
- Kathleen Möller
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Sotirios Ntovas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Hocke
- Medical Department II, Helios Klinikum Meiningen, Germany
| | - Wei On
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Simon M. Everett
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Barbara Braden
- Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, United Kingdom
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch-Oderland, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound (BICUS) at Medical University Brandenburg, Neuruppin, Germany
| | - Benjamin Misselwitz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nan Ge
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Siyu Sun
- Department of Endoscopy Center, Shengjing Hospital of China Medical University, Liaoning Province, China
| | - Michael Gerber
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Siegbert Faiss
- Medical Department I/Gastroenterology, Sana Hospital Lichtenberg, Berlin, Germany
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin der Kliniken (DAIM) Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Soliman M, Guys N, Liu P, Moshiri M, Menias CO, Mellnick VM, Savas H, Badawy M, Elsayes KM, Gaballah AH. Multimodality imaging findings of infection-induced tumors. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3930-3953. [PMID: 36069914 DOI: 10.1007/s00261-022-03651-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 01/18/2023]
Abstract
Several infections can predispose to certain malignancies in different body parts. These infections include viral, bacterial, and fungal pathogens. Imaging plays a vital role in the diagnosis, staging, and management of these neoplastic conditions. Furthermore, it can help in differentiating infection-related non-neoplastic processes that can mimic malignancies. Both radiologists and clinicians should be familiar with these conditions. This review discusses the epidemiology, pathogenesis, and imaging features of infection-related tumors.
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Affiliation(s)
- Moataz Soliman
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nicholas Guys
- Department of Diagnostic Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Peter Liu
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Mariam Moshiri
- Department of Diagnostic Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Vincent M Mellnick
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hatice Savas
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - Ayman H Gaballah
- Department of Diagnostic Radiology, University of Missouri, Columbia, MO, USA.
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Abstract
Kaposi sarcoma (KS) is a form of cancer that primarily appears on the skin but can potentially involve internal organs. There are several types of KS. The purpose of this article is to discuss the manifestations of KS and their appearance on imaging, the differential diagnoses associated with these findings, and molecular markers associated with KS that can aid appropriate diagnosis and therapy.
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Disseminated AIDS-Related Kaposi Sarcoma Immune Reconstitution Inflammatory Syndrome With Infiltrative Liver Disease. ACG Case Rep J 2021; 8:e00660. [PMID: 34646902 PMCID: PMC8500654 DOI: 10.14309/crj.0000000000000660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022] Open
Abstract
Clinically significant hepatic acquired immunodeficiency syndrome-related Kaposi sarcoma is rarely described in the literature. Kaposi sarcoma immune reconstitution inflammatory syndrome may play a role in the rapid progression of clinically insignificant to significant liver disease. We present an acquired immunodeficiency syndrome patient with disseminated Kaposi sarcoma that developed 3-6 weeks after initiation of highly active antiretroviral therapy.
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Li D, Baloch Z, Zhao Y, Bai L, Wang X, Wang G, Zhang AM, Lan K, Xia X. Establishment of Tree Shrew Animal Model for Kaposi's Sarcoma-Associated Herpesvirus (HHV-8) Infection. Front Microbiol 2021; 12:710067. [PMID: 34603235 PMCID: PMC8481836 DOI: 10.3389/fmicb.2021.710067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/01/2021] [Indexed: 01/22/2023] Open
Abstract
Kaposi’s sarcoma-associated herpesvirus (KSHV) is the most common cause of Kaposi’s sarcoma (KS) and other malignant growths in humans. However, the lack of a KSHV-infected small animal model has hampered understanding of the mechanisms of KSHV infection, virus replication, pathogenesis, and persistence. This study was designed to explore the susceptibility of tree shrews as a possible KSHV-infected small animal model. A recombinant GFP (latent)/RFP (lytic)-positive rKSHV.219 strain was used to infect primary cells cultured from different tissues of tree shrews as an in vitro model and adult tree shrews as an in vivo model. KSHV latent nuclear antigen (LANA) and DNA were successfully detected in primary cells of tree shrews. Among them, tree shrew kidney epithelial cells (TSKEC) were the most susceptible cells to KSHV infection compared to other cells. KSHV genomic DNA, mRNA, and KSHV-specific proteins were readily detected in the TSKEC cultured up to 32 dpi. Moreover, KSHV DNA and mRNA transcription were also readily detected in the peripheral blood mononuclear cells (PBMCs) and various tissues of tree shrews infected with KSHV. Haematoxylin and eosin (HE) staining showed lymphocyte infiltration, lymphoid tissue focal aggregation, alveolar wall thickening, hepatocyte edema, hepatic necrosis in the spleen, lung, and liver of KSHV-infected animals. Additionally, immune-histochemical (IHC) staining showed that LANA or ORF62-positive cells were present in the spleen, lung, liver, and kidney of KSHV-infected tree shrews. Here, we have successfully established in vitro and in vivo KSHV latent infection in tree shrews. This small animal model is not only useful for studying the pathogenesis of KSHV in vivo but can also be a useful model to study transmission routes of viral infection and a useful platform to characterize the novel therapeutics against KSHV.
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Affiliation(s)
- Daoqun Li
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China.,Institute of Basic Medicine, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Yang Zhao
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Lei Bai
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, China
| | - Xing Wang
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, China
| | - Gang Wang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - A-Mei Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
| | - Ke Lan
- State Key Laboratory of Virology, College of Life Sciences, Medical Research Institute, Wuhan University, Wuhan, China
| | - Xueshan Xia
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China
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Zhao CJ, Ma GZ, Wang YJ, Wang JH. Splenic Kaposi’s sarcoma in a human immunodeficiency virus-negative patient: A case report. World J Clin Cases 2021; 9:4765-4771. [PMID: 34222445 PMCID: PMC8223844 DOI: 10.12998/wjcc.v9.i18.4765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/22/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Kaposi’s sarcoma (KS) is a malignancy that usually affects the skin of the lower extremities, and may involve internal organs. It originates from the vascular endothelium. It is well known that the development of KS is associated with human herpes virus 8 (i.e. HHV8) infections. Sporadic KS cases have mainly been found in Africa. Isolated splenic KS in Asia has rarely been reported. We present here a case of KS primarily involving the spleen in a human immunodeficiency virus (HIV)-negative Chinese patient.
CASE SUMMARY A 50-year-old male patient was admitted to hospital due to abdominal distension and discomfort, reduced food intake and weight loss. Medical examination revealed that the patient had moderate anemia, a low platelet count, slight fatty liver and a huge mass in the spleen. Spleen lymphoma was considered. An anti-HIV test was negative. The whole spleen was surgically excised. The final pathological diagnosis was nodular stage spleen KS, and the patient underwent total splenectomy. He recovered well and was discharged from hospital 12 d after surgery. Two weeks later, the patient developed liver metastasis and died within 1 mo after surgery.
CONCLUSION KS is difficult to diagnose and pathological examination is necessary. KS has a poor prognosis and should be diagnosed and treated early to improve survival.
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Affiliation(s)
- Chuan-Jie Zhao
- Department of Hepatobiliary Surgery, Liaocheng Second People’s Hospital, Linqing 252600, Shandong Province, China
| | - Guang-Zhen Ma
- Department of Pathology, Liaocheng Second People’s Hospital, Linqing 252600, Shandong Province, China
| | - Yan-Jun Wang
- Department of Medical Oncology, Liaocheng Second People’s Hospital, Linqing 252600, Shandong Province, China
| | - Jin-Hong Wang
- College of Life Science, Shaanxi Normal University, Xi'an 710119, Shaanxi Province, China
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Gwiti P, Jenkins M, Sutak J, Melegh Z. Two cases of rare HHV8-driven intravascular lymphoma with synchronous Kaposi sarcoma, both diagnosed at autopsy in renal transplant recipients. AUTOPSY AND CASE REPORTS 2020; 10:e2020206. [PMID: 33344322 PMCID: PMC7707703 DOI: 10.4322/acr.2020.206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We present the first report of two rare yet remarkably similar autopsy cases of Kaposi sarcoma (KS) and intravascular human herpesvirus 8 (HHV8) positive lymphoproliferative disorder in renal transplant patients. It is well established that HHV8 infection causes Kaposi sarcoma (KS). More recently, it is recognized that HHV8 is also related to several lymphoproliferative conditions. These are poorly characterized and often difficult to diagnose. In both cases described herein, the diagnoses of multifocal hepatic KS and intravascular HHV8 positive (EBV negative) systemic diffuse large B-cell lymphoma, NOS were made at autopsy. Given the findings we describe in cases with fatal outcomes, we discuss the implications of HHV8 screening in solid allograft recipients.
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Affiliation(s)
- Paida Gwiti
- Peterborough City Hospital, Department of Cellular Pathology, Peterborough, UK
| | - Megan Jenkins
- Royal Liverpool University Hospital, Forensic Pathology Unit, Liverpool, UK
| | - Judit Sutak
- Department of Cellular Pathology, North Bristol NHS Trust, Bristol, UK
| | - Zsombor Melegh
- Department of Cellular Pathology, North Bristol NHS Trust, Bristol, UK
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Flores Córdova E, Mathew M, Mutneja H, Gonzalez Caldito E, Demetria M. An Uncommon Presentation of Extrahepatic Cholestasis due to Single Biliary Stricture From Kaposi Sarcoma. Cureus 2020; 12:e8913. [PMID: 32742879 PMCID: PMC7389956 DOI: 10.7759/cureus.8913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Kaposi sarcoma is one of the acquired immunodeficiency syndrome (AIDS) defining diseases. AIDS-associated Kaposi sarcoma affects primarily the skin and the lungs. Although gastrointestinal involvement is relatively common, biliary tract involvement has rarely been reported. It has been associated mostly with extension from liver disease. We describe an uncommon presentation of disseminated Kaposi sarcoma causing extrahepatic cholestasis due to extrahepatic biliary tract involvement that resolved after sphincterotomy with biliary stenting. We present a case of a 35-year-old African American male diagnosed with human immunodeficiency virus (HIV) infection in 2005. He presented with AIDS after discontinuation of antiretroviral therapy for one year, subsequently being diagnosed with systemic Kaposi sarcoma. He presented with signs and symptoms of obstructive biliary disease, including jaundice, abdominal pain, fatigue, and fever. We encountered a rare presentation of malignant single extrahepatic biliary stenosis secondary to biliary Kaposi sarcoma. The biochemical pattern markedly improved after endoscopic retrograde cholangiopancreatography with sphincterotomy and stenting. However, and despite the resumption of combined antiretroviral therapy, deep immunosuppression caused worsening clinical condition and death five months after initial presentation. Certainly, among the multiple etiologies of biliary obstruction in AIDS, Kaposi sarcoma is one to consider.
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Affiliation(s)
| | - Madhu Mathew
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Hemant Mutneja
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | | | - Melchor Demetria
- Gastroenterology and Hepatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
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Lazăr DC, Avram MF, Romoșan I, Văcariu V, Goldiș A, Cornianu M. Malignant hepatic vascular tumors in adults: Characteristics, diagnostic difficulties and current management. World J Clin Oncol 2019; 10:110-135. [PMID: 30949442 PMCID: PMC6441663 DOI: 10.5306/wjco.v10.i3.110] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/23/2019] [Accepted: 03/12/2019] [Indexed: 02/06/2023] Open
Abstract
Malignant vascular tumors of the liver include rare primary hepatic mesenchymal tumors developed in the background of a normal liver parenchyma. Most of them are detected incidentally by the increased use of performing imaging techniques. Their diagnosis is challenging, involving clinical and imaging criteria, with final confirmation by histology and immunohistochemistry. Surgery represents the mainstay of treatment. Liver transplantation (LT) has improved substantially the prognosis of hepatic epithelioid hemangioendothelioma (HEHE), with 5-year patient survival rates of up to 81%, based on the European Liver Intestine Transplantation Association-European Liver Transplant Registry study. Unfortunately, the results of surgery and LT are dismal in cases of hepatic angiosarcoma (HAS). Due to the disappointing results of very short survival periods of approximately 6-7 mo after LT, because of tumor recurrence and rapid progression of the disease, HAS is considered an absolute contraindication to LT. Recurrences after surgical resection are high in cases of HEHE and invariably present in cases of HAS. The discovery of reliable prognostic markers and the elaboration of prognostic scores following LT are needed to provide the best therapeutic choice for each patient. Studies on a few patients have demonstrated the stabilization of the disease in a proportion of patients with hepatic vascular tumors using novel targeted antiangiogenic agents, cytokines or immunotherapy. These new approaches, alone or in combination with other therapeutic modalities, such as surgery and classical chemotherapy, need further investigation to assess their role in prolonging patient survival. Personalized therapeutic algorithms according to the histopathological features, behavior, molecular biology and genetics of the tumors should be elaborated in the near future for the management of patients diagnosed with primary malignant vascular tumors of the liver.
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Affiliation(s)
- Daniela Cornelia Lazăr
- Department of Internal Medicine I, University Medical Clinic, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
| | - Mihaela Flavia Avram
- Department of Surgery X, 1st Surgery Clinic, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
| | - Ioan Romoșan
- Department of Internal Medicine I, University Medical Clinic, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
| | - Violetta Văcariu
- Department of Internal Medicine I, University Medical Clinic, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
| | - Adrian Goldiș
- Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
| | - Mărioara Cornianu
- Department of Pathology, University of Medicine and Pharmacy “Victor Babeş”, Timişoara 300041, Romania
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