当前位置: X-MOL 学术Am. J. Surg. Pathol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Histologic Variants of Kaposi Sarcoma in the Gastrointestinal Tract: A Contemporary Multi-institutional Clinicopathologic Analysis of 46 Cases
The American Journal of Surgical Pathology ( IF 5.6 ) Pub Date : 2022-11-01 , DOI: 10.1097/pas.0000000000001937
Wei Zheng 1 , Rebecca C Obeng 2 , Rondell P Graham 3 , Shu Lui 1 , Jerome Cheng 4 , Borislav A Alexiev 5 , Brian Quigley 1 , Alyssa Krasinskas 1 , Guang-Yu Yang 5, 6 , David Escobar 5 , Xiuli Liu 7 , Pooja Navale 7 , Michelle D Reid 1 , Maria Westerhoff 4 , Yue Xue 5, 6
Affiliation  

Kaposi sarcoma (KS) can pose diagnostic challenges in biopsy specimens. Multiple histologic variants of cutaneous KS have been described; however, the histomorphologic spectrum of gastrointestinal (GI) KS has not been systematically studied. This large series comprehensively evaluated 46 cases of KS involving the GI tract and identified 7 histomorphologic variants, some that have not been previously described. Five of them are inconspicuous but have unique morphologic patterns, including lymphangioma/lymphangiectatic–like (n=17), mucosal hemorrhage/telangiectatic–like (n=17), mucosal inflammation–like (n=15), granulation tissue–like (n=13), and mucosal prolapse–like (n=4) variants. These variants can be easily misdiagnosed or misinterpreted on routine examination if KS is not considered, and if the immunohistochemical stain for human herpesvirus-8 is not performed. The other 2 morphologic variants present as spindle cell proliferations and are the GI stromal tumor–like (n=8) and inflammatory myofibroblastic tumor–like (n=2). These variants raise a broad differential diagnosis of spindle cell tumors of the GI tract and could pose diagnostic challenges. In summary, GI KS lesions exhibit variable, often unconventional histomorphologic patterns. KS should be included in the differential diagnosis even if features of conventional KS are not seen, particularly in limited biopsies in immunocompromised patients, such as those with human immunodeficiency virus infection. Although the clinical significance of these morphologic variants is yet to be determined, they are nonetheless important from a diagnostic standpoint. Misdiagnosis and delay in appropriate management can be avoided by recognizing the morphologic diversity of GI KS and appropriately utilizing the human herpesvirus-8 immunohistochemical stain.



中文翻译:

胃肠道卡波西肉瘤的组织学变异:46 例现代多中心临床病理学分析

卡波西肉瘤 (KS) 可能对活检标本的诊断提出挑战。已经描述了皮肤 KS 的多种组织学变体;然而,尚未系统地研究胃肠道 (GI) KS 的组织形态学谱。这个大型系列综合评估了 46 例涉及胃肠道的 KS 病例,并确定了 7 种组织形态学变异,其中一些以前没有被描述过。其中五个不显眼但具有独特的形态模式,包括淋巴管瘤/淋巴管扩张样(n = 17),粘膜出血/毛细血管扩张样(n = 17),粘膜炎症样(n = 15),肉芽组织样( n=13) 和粘膜脱垂样 (n=4) 变体。如果不考虑 KS,这些变异很容易在常规检查中被误诊或误解,如果没有对人疱疹病毒 8 进行免疫组织化学染色。其他 2 种形态学变异表现为梭形细胞增生,分别是胃肠道间质瘤样 (n=8) 和炎性肌纤维母细胞瘤样 (n=2)。这些变异引起了胃肠道梭形细胞肿瘤的广泛鉴别诊断,并可能带来诊断挑战。总之,GI KS 病变表现出可变的、通常是非常规的组织形态学模式。即使未见常规 KS 的特征,KS 也应包括在鉴别诊断中,特别是在免疫功能低下患者(例如感染人类免疫缺陷病毒的患者)的有限活检中。尽管这些形态学变异的临床意义尚未确定,但从诊断的角度来看它们仍然很重要。

更新日期:2022-10-15
down
wechat
bug