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. 2016 Sep 19;3(7):000493.
doi: 10.12890/2016_000493. eCollection 2016.

Kaposi's Sarcoma Presenting as Lymphadenopathy in an Immunocompetent Patient

Hana Zoubeidi  1 , Zohra Aydi  1 , Fatma Daoud  1 , Imen Rachdi  1 , Wafa Koubaa  2 , Raja Jouini  2 , Lilia Baili  1 , Achraf Debbiche  2 , Besma Ben Dhaou  1 , Fatma Boussema  1
Affiliations

Kaposi's Sarcoma Presenting as Lymphadenopathy in an Immunocompetent Patient

Hana Zoubeidi et al. Eur J Case Rep Intern Med. .

Abstract

Introduction: Kaposi's sarcoma (KS) is an angioproliferative disorder first described in 1872 by Moritz Kaposi. Four main clinical presentations of KS have been described: classic, endemic, iatrogenic and epidemic. KS involvement of the lymph nodes is extremely uncommon in the classical variant form, especially if it precedes the skin manifestations. We describe the case of an elderly HIV-negative patient presenting with lymphadenopathy who was found to have KS.

Case report: A 67-year-old patient was admitted for exploration of polyadenopathies in the context of a general decline in health. Physical examination revealed an erythematosus left lower limb rash associated with angiomatous nodules and multiple lymphadenopathies. The diagnosis of erysipelas in the left leg was retained and the patient was treated with good evolution of the rash but persistence of the angiomatous nodules and the polyadenopathies. Skin and lymph node biopsies led to a diagnosis of KS. The patient is proposed for polychemotherapy.

Conclusion: KS must be suspected in lymphadenopathies despite the absence of typical cutaneous signs of the disease and in immunocompetent patients.

Learning points: Involvement of the lymph nodes is extremely uncommon in the classical variant form of Kaposi's sarcoma (KS).Human herpes virus-8 is an important cofactor in all forms of KS.Pathology and immunohistochemistry are key to diagnosing KS.KS must be suspected in lymphadenopathies without typical cutaneous signs of the disease and in immunocompetent patients.

Keywords: Kaposi’s sarcoma (KS); human herpes virus-8 (HHV-8); lymphadenopathy.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Skin biopsy showing a fusocellular proliferation in standard staining (HE) and medium magnification.
Figure 2
Figure 2
Standard staining (HE), medium magnification showing a dense intranodal proliferation and rich vascular cavities.
Figure 3
Figure 3
Positivity of Ac ant-HHV8 in Immunohistochemical study.
Figure 4
Figure 4
Nuclear Positivity of Ac anti-HHV8 in Immunohistochemical study in nuclei tumoral cells.
See this image and copyright information in PMC

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