bubble_chart Overview

Kaposi's sarcoma, also known as multiple hemorrhagic sarcoma, is a rare multicentric vascular tumor. Clinically, it can be divided into at least four types: the classic or European type, the African type, the AIDS-related type, and the transplant-associated Kaposi's sarcoma. The classic type has been reported in the Xinjiang region of China, primarily among ethnic minorities such as the Uyghurs. With the widespread adoption of organ transplants and the extensive use of immunosuppressants, the incidence of transplant-associated Kaposi's sarcoma has increased. In particular, with the spread of AIDS in recent years, AIDS-related Kaposi's sarcoma has significantly risen, progressing rapidly, being difficult to treat, and exhibiting a high mortality rate.

bubble_chart Clinical Manifestations

1. Classic type: Mainly seen in males, the skin lesions initially appear as small papules, gradually forming patches, nodules, or tumors, which are light red or purplish-red. They commonly occur on the lower limbs (especially the arch of the foot), hands, and forearms. Ulcers may also form, and the nodules often distribute along veins in a beaded pattern, potentially involving internal organs.
2. AIDS-associated type: The skin lesions initially manifest as red or purplish macules and papules or papules surrounded by a pale halo, later enlarging into nodules or patches. The lesions are often multiple, primarily distributed on the trunk, head, face, and upper limbs. The oral cavity, gastrointestinal tract, and conjunctiva may also be affected, seen in AIDS patients or male homosexuals.
3. Transplant-associated Kaposi's sarcoma: Occurs after organ transplantation with the use of immunosuppressants (such as cyclosporine). The skin lesions start as small red patches, rapidly expanding and potentially spreading across the entire skin and mucous membranes. Lymph nodes and internal organs may also be involved. Discontinuing immunosuppressants may lead to the regression of the lesions.

bubble_chart Diagnosis

1. Medical history: Ethnic minority, history of organ transplantation with immunosuppressant use, AIDS, or male homosexuality;
2. Main symptoms and signs;
3. Histopathology: The tumor contains numerous regular clefts lined by slender, grade I atypical cells. Red blood cells and hemosiderin-laden macrophages are visible within the clefts. Additionally, varying numbers of spindle cells are present, some with large, irregular nuclei showing atypia.

bubble_chart Treatment Measures

1. Radiotherapy or electron accelerator therapy;
2. Cryotherapy and laser therapy;
3. Chemotherapy: (1) Single-agent chemotherapy: Vincristine, Actinomycin D; (2) Combination chemotherapy: Commonly uses 2-3 drugs in combination, including Vincristine, Vinblastine, Adriamycin, Dacarbazine;
4. Immunotherapy: Mainly used for AIDS-related types, commonly using Interferon and Interleukin-II;
5. Surgical treatment: Primarily used for single lesions.

Medication principles: For single small lesions, surgical cryotherapy or laser therapy may be performed; for advanced stages or cases unsuitable for radiotherapy, single-agent or combination chemotherapy may be chosen; for AIDS-related types, in addition to treating the primary disease, immunotherapy or a combination with chemotherapy may be selected.

bubble_chart Cure Criteria

1. Cure: Tumor disappears after treatment with no recurrence;
2. Improvement: Partial regression or shrinkage of tumor after treatment, or recurrence;
3. No cure: No response to chemotherapy or radiotherapy, or recurrence after resection.