PMC5509186_01
Gross appearance of Kaposi's sarcoma in various organs. (a) Multiple yellowish nodules surrounding the bronchovascular structures of the left lung. (b) A well-circumscribed lesion (arrow) 0.5 cm in diameter in the liver. (c) One nodular tumor (arrow) in the left kidney. (d) Two solid nodules at the lesser curvature surrounded by smaller lesions over the gastric mucosa. (e-g) Multiple polypoid or nodular lesions found throughout the entire alimentary tract
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F1
On cutting, hemorrhagic, yellowish nodules involving all segments of all lobes were found [Figure 1a]. Some foci of KS lesions were observed in the liver appearing as small nodules [Figure 1b]. The kidneys weighed 120 g each and were also involved by KS, especially in the cortical areas [Figure 1c]. Those tumors presented with polypoid, nodular, and/or ulcerative patterns [Figure 1d-g].
Histological findings of Kaposi's sarcoma. (a) Skin: proliferating spindle cells and split-like vessels in the dermis (H and E, x200). (b) Skin: human herpes virus type-8 positive (arrows) spindle cells (IHC, x400). (c) Lung: Bronchocentric and angiocentric patterns (H and E, x40)
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F2
Microscopically, all representative tumor nodules were composed of spindle cells in fascicles or bundles or storiform, vascular channels filled with erythrocytes lined by flat endothelial cells and extravasated erythrocytes [Figure 2a], with HHV-8 antigen positivity [Figure 2b], diagnostic of KS. Multiple disseminated KS nodules involving the lungs surrounded the bronchioles and vessels (bronchocentric and angiocentric patterns), which were the cause of death in this patient [Figure 2c].