Clinico-pathologic Study and Detection of Human Herpesvirus 8 sequence of Kaposi's Sarcoma in Korea

Ahn, Soo Jin; Yun, Woo Jin; Chang, Sung Eun; Lee, Mi Woo; Choi, Jee Ho; Moon, Key Chan; Koh, Jai Kyoung

Abstract

BACKGROUND
Kaposi's sarcoma (KS) is a vascular neoplasm that was rarely seen before the AIDS and transplantation era. The isolation of human herpesvirus 8 (HHV-8) in all forms of KS strongly suggests a role of this agent in the pathogenesis. OBJECTIVE: The purpose of this study was to evaluate the clinical and histopathological features of KS and assess the presence of HHV-8 sequences in Korea. METHODS: The medical records and histopathologic slides of patients with KS, who were diagnosed at Asan Medical Center from 1989 to 2005, were reviewed. We also performed polymerase chain reaction (PCR) to find out the presence of HHV-8. RESULTS: 1.Among the 22 patients, classic KS was found in 9 and iatrogenic immunosuppressive-associated KS in 13 patients. 2.Clinical features were varied, usually limiting to the skin of the extremities, however, involvement of internal organs and mucosa was also detected. 3. The histology of cutaneous lesions associated with various clinical forms of KS was essentially identical, however, it presented different features according to their stage. 4. HHV-8 sequences were identified in all cases of KS, including the lesions of internal organs. 5.Classic KS responded well to radiation therapy, thalidomide or chemotherapy, except 2 patients. Iatrogenic immunosuppressive KS improved generally after radiation therapy, IFN-alpha, or chemotherapy, but some of the patients died due to underlying diseases. CONCLUSION: KS is a rare vascular neoplasm. We retrospectively studied twenty-two cases, and HHV-8 were detected in all cases, these supporting HHV-8 as the causative agent.