[Kaposi's sarcoma associated with human immunodeficiency virus infection: a clinical, histological, immunohistochemical, serological and development review].
BACKGROUND: A clinical, histologic, immunohistochemical, serological and evolutive review was carried out in 12 cases of Kaposi's sarcoma, representing 5.5% (12/217) of the HIV positive patients consecutively seen during an 18 month period. METHODS: The patients were clinically examined and staging was assessed. Skin biopsy was performed in all cases, and of healthy perilesional skin in eight, with HE and Perls stains. Immunohistochemical study of the skin lesions was carried out with monoclonal anti-collagen, anti-laminin, anti-HLA-DR, OKM5 and UEA-I antibodies. Statistical analysis was carried out with chi-square and Student's tests. RESULTS: There were 11 homosexual males and a prostitute parenteral drugs addicted female. The clinical presentation spectrum ranged from a single longitudinal lesion to multiple disseminated lesions in the whole skin and mucosae. Visceral or lymph node involvement was shown in three cases. Histological study also showed a spectrum of lesions from initial endothelial proliferation in perilesional healthy skin areas to mixed fusocellular and endothelial proliferation in nodular lesions. The immunohistochemical study with the appropriate monoclonal antibodies demonstrated the endothelial origin of cellular components. Some laboratory parameters (beta-2-microglobulin, total lymphocytes/mm3, total CD4 cells/mm3) were useful for prognostic evaluation at the time of diagnosis. CONCLUSIONS: KS associated with HIV infection is a vascular hyperplasia of endothelial origin virtually exclusive of homosexual males. Although the diagnose of KS does not determine by itself the vital prognosis of these patients, some laboratory parameters at the time of diagnosis are useful for the prognosis of HIV infection.