KS - multiple, affecting the whole body malignant cancer of the lymph and blood vessels that affects the skin, internal organs, lymphatic system and mucous membranes.Most often suffer from Kaposi's sarcoma people aged from 38 to 75 years.In men, this malignant vascular tumors are eight times more often than women.According to statistics, the disease is most commonly found in the countries of the African continent.In Europe and the United States, the disease is diagnosed in 20% of AIDS sufferers gay
Kaposi's sarcoma - Causes
main proven causal factor in the development of Kaposi's sarcoma is a type VIII human herpes virus that is transmitted with the saliva, blood or sexual contact.For some time before the onset of Kaposi's sarcoma lesions, due to the presence of the virus in the blood, the human body produces specific antibodies.Despite this, the virus herpes causes Kaposi's sarcoma.The disease develops as a result of extremely serious violations of the immune defense (people with AI
risk groups include people with transplanted organs (recipients), people from sub-Saharan Africa, older men of Mediterranean origin, HIV-infected men (mostly gay).
significantly increases the risk of infection and frequent changes of sexual partners.The virus was detected in the rectum, the urethra, in prostatic secretions and semen.Often infection Kaposi's sarcoma occurs during administration of the drug injecting equipment to several people.In addition, human herpes virus type VIII can rarely transmitted from mother to fetus, and on the contrary, often transmission occurs by kissing, as it occurs in the saliva in very large quantities.
less significant risk factors for this cancer are: frostbite of extremities, trauma, recurrent erysipelas, prolonged intake of antibiotics and corticosteroids, long limb lymphedema.
Some experts argue that the Kaposi's sarcoma starts its development from the endothelium of lymphatic and blood capillaries, being therefore true malignancy, and pronounced proliferation of endothelial cells, which occurs under the influence of humoral factors
KS - symptoms
clinical picturethe disease is varied and depends on the duration of the disease.In the initial stages of sarcoma occur at different contours and dimensions of reddish-bluish spots, and pink uzelkovopodobnye elements which then acquire a bluish color.As the flow of Kaposi's sarcoma, rashes take the form of different sizes knotted elements infiltrated reddish-bluish color.These nodularity tend to merge, resulting in a large hilly foci formed with sharply painful sores.In the focus skin sealed, swollen, purple-bluish color.The main foci are localized on the skin of the distal extremities (94% of the lower extremities - anterolateral surface of the tibia and foot) and tend to be located near the surface veins.Frequently observed symmetry of the affected limb.
In its current tumor can be sub-acute, acute and chronic.Acute for Kaposi's sarcoma is characterized by rapidly progressive symptoms manifested generalized skin lesions in the form of a plurality of nodular formations on the trunk, face and extremities, and fever.These symptoms are accompanied by visceral and / or lymph nodes.The duration of the acute form of the flow from two months to two years.When subacute sarcoma skin rash generalization occurs much less frequently.Chronic characterized by a gradual progression of skin lesions in the form of plaque and the spotty-nodular elements.The duration of the chronic form of eight years or more
Clinical forms of Kaposi's sarcoma
• The classic form of Kaposi's sarcoma is the most common and is characterized by the presence of tumor, nodes, infiltrative plaques, nodules and spots.In most patients the disease begins to manifest with the appearance of individual elements spotted, 30% of patients appear nodules and rarely with minor swelling.
Usually the lesions are located on the skin of the lower extremities, on the front surface of the tibia and dorsum of the foot.However, the rash can also occur in other areas of the skin (penis, hard palate, cheeks, eyelids, ears).During the onset of the full development of the disease in 95% of patients process is symmetrical, which means that the characteristics of Kaposi's sarcoma is a symmetry, and the prevalence of multifocal lesions.
the development of Kaposi's sarcoma starts with the appearance of a reddish-brown or reddish-cyanotic different sizes delineated spots, which over time gradually increased, eventually reaching about five centimeters in diameter.As the color of the spots is changing, gradually acquiring a dark brown color.The surface is smooth spots, sometimes covered with grayish scales.As further background to the disease spots appear infiltrated nodes, nodules and plaques.Beginners formed nodules are similar in shape to the spherical or flat small pea pink (eventually turn brown).Nodules can be located both in isolation and in droves, and merge into larger units or plaque.
infiltrative plaques are one centimeter to the size of the palm of a child and usually have a round (sometimes oval) shape.At the beginning of the disease plaque surface is uneven, sometimes covered with papillomatous growths.Sometimes there are significantly elevated above the surface of the skin hemispherical tumor bluish-brown hue of up to the size of a walnut.As a result of the collapse of the tumors formed deep ulcers with lumpy krovjanisto gangrenous-down and bluish-purple Turned edges.Characteristic features include pronounced swelling of the affected limb, and the development of elephantiasis, lymphostasis.
Sometimes the first symptoms are swelling.Patients concerned about burning, itching, ulceration in the case of items marked a sharp excruciating pain.Often, in the pathological process they are involved in the oral mucosa.In this case, rash observed in the pharynx, the larynx, the language, the lips, cheeks and hard palate.By its color and nodular-infiltrative tumor formation are very different from the surrounding mucosa and have a cherry-red color.Often there is a defeat of the musculoskeletal system, lymph nodes and internal organs.Separate pockets with prolonged duration of conception regress, but complete spontaneous remission marked by no more than 2% of patients
• Endemic Kaposi's sarcoma.This form of the disease occurs most often in young men and manifests tumor, infiltrative and nodules, which are mainly located in the extremities.Lymph system is very rare.In African children up to ten years mostly found limfadenopatichesky version of endemic forms of Kaposi's sarcoma.This form is characterized by malignant course with a strong and swift poliadenopatiey involvement in the pathological process of many internal organs.Relapses occur much faster than relapses in the classical form.Eruptions are highly sensitive to chemotherapy and radiotherapy.The forecast of this form of sarcoma is extremely unfavorable - patients die within the period from five months to two years
• epidemic form of Kaposi's sarcoma.This form is considered a kind of marker for AIDS.Epidemic Kaposi's sarcoma is characterized by its aggressive course, multiple skin lesions, mandatory involvement of lymph nodes and fast visceral
• Iatrogenic form of Kaposi's sarcoma.This form is typically observed in individuals treated with immunosuppressive drugs after a kidney transplant and cancer patients treated with cytotoxic agents
• The acute form of Kaposi's sarcoma.This form is characterized by the rapid current, generalization process involving internal organs.The general condition of the patient is deteriorating as rapidly.Lethal outcome often comes after a few months since the onset of the disease
• chronic form of Kaposi's sarcoma differ benign occurrence of the past ten years or more
Kaposi's sarcoma - diagnosis
detection in human type VIII herpes has not yet been said about the possible developmentKaposi's sarcoma.In case of suspicion of the presence of this disease shows a complete inspection of the skin, genital and oral mucosa.In the case of the marks on the skin, for a fair determination of the type of tumor biopsy shows.To diagnose pulmonary form of Kaposi's sarcoma demonstrated a bronchoscopy and chest radiograph.Diagnosis of intestinal form is carried out by means of a colonoscopy.Differential diagnosis is carried out with the following diseases: psevdosarkoma sarcoma, melanoma, pyogenic granuloma, leiomyoma, synovial sarcoma, fibrosarcoma
Kaposi's sarcoma - treated
treatment of Kaposi's sarcoma depends on the clinical course and forms of the disease.The basal agents are cytotoxic agents: spirobromin, adriablastin, cyclophosphamide, vinblastine, vincristine, prospidin.These drugs are prescribed as combined or separately.When using interferon treatment efficacy significantly increased.
as a topical treatment in the presence of a large area of defeats radiation therapy.Also, radiation therapy is ideal for those parts of the body (the penis, feet and so on.), Where other therapies cause severe pain.
Some tumors may cure minor doses of chemotherapy (drugs administered hypodermic needle).