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ABSTRACT
Background
Non-cutaneous KS is an angioproliferative neoplasm; most non-cutaneous KS cases are incidental diagnoses and common in RVD-reactive individuals. Although it is not common, KS of the mucocutaneous site has a poor prognosis compared to cutaneous/skin KS. Identifying the key histopathological differentiators and potential diagnostic markers for non-cutaneous KS will aid in accurate and timely diagnosis as well as the timely initiation of accurate personalised therapy.
Method
This was a retrospective study which investigated all cases with histopathological diagnosis of Kaposi sarcoma with non-cutaneous origin. The cases were diagnosed at the department of Anatomical Pathology, Dr George Mukhari Tertiary Laboratory, from 01 January 2012 to 31 December 2022. Data was retrieved from the laboratory information system using Systematised Nomenclature of Medicine Codes and word search engines. The clinicopathological data were analysed using STATA-v18.
Result
The study consisted of 74 non-cutaneous KS cases with male predominance, comprising 52,70% (n=39) compared to females with 47,3% (n=35). The mean age was 36,11 years (range 4 to 64 years). The majority of the cases (n=64, 86,49%) were HIV positive with 89,06% (n=57) being on antiretroviral therapy. The average CD4 T lymphocyte count was 312 (200-499 cells/Ul) in n=26 cases, (44,83%). The commonest presenting clinical features were purple violaceous lesions and lymphadenopathy, each at 14,86% (n=11). The commonly affected anatomical sites were gastrointestinal at 35.14% (n=26). Microscopically, all cases presented with vasoformative spindle cells. HHV-8 immunostaining was positive in all the cases.
Conclusion
The study revealed a wide age range and male predominance in patients diagnosed with non-cutaneous KS. Most female patients were younger. Non-cutaneous KS prevalence was not directly linked to immunosuppression, this underscores the need for further molecular pathology studies and clinicians’ awareness on presenting symptoms.