The coexistence of lymphangiosarcoma and Kaposi's sarcoma in a renal transplant recipient

Article Abstract:

Kaposi's sarcoma was one of the first disorders to be recognized as part of the spectrum of AIDS. This cancer, however, is not limited to AIDS patients, although it is certainly more common among patients with compromised immune function. Kidney transplant recipients fall into this category, and are subsequently at higher risk for Kaposi's sarcoma. Curiously, kidney transplant recipients who develop Kaposi's sarcoma are generally of Jewish and Mediterranean ancestry, just as is the case for classic sporadic Kaposi's sarcoma. The origin and development of Kaposi's sarcoma is uncertain, but it is thought to arise from an endothelial (surface) cell. This origin is similar to that suspected for another cancer, lymphangiosarcoma, which arises from cells of the lymphatic vessels. Therefore, the origin of Kaposi's sarcoma (KS) and lymphangiosarcoma (LS) may be the same, and these two cancers may differ only in the subsequent course of differentiation taken by the cancer. In this light, it is interesting that researchers have found a patient who developed both KS and LS after receiving a kidney transplantation. The patient received a cadaveric kidney in 1971, and skin lesions consistent with KS developed one year later, although they were not recognized as KS at that time. Fourteen years later, the patient developed the blister-like lesions of LS. It is generally believed that the development and progression of LS is slower than that of KS; the different times of onset of symptoms in this patient are consistent with the different rates of development of these two cancers. In the present case, the cancers were very slowly progressive. After recognition of the nature of the patient's skin lesions, treatment with vinblastine was given. The Kaposi's lesions partially resolved and there has been no progression of the lymphangiosarcoma for the year following treatment. The simultaneous occurrence of Kaposi's sarcoma and lymphangiosarcoma lends credence to the notion that these two cancers may arise in the same cells and may differ only in the course of progression of the cancerous cells thereafter. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Kidneys, Kidney transplantation

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Kaposi's sarcoma in immunosuppression: possibly the result of a dual viral infection

Article Abstract:

Kaposi's sarcoma, previously very rare, has become one of the hallmarks of AIDS (acquired immunodeficiency syndrome). Although it is especially common among homosexual men with AIDS, it may occur in other immunocompromized individuals. The case of a 28-year-old kidney transplant recipient suggests that Kaposi's sarcoma may result from a dual infection, possibly with cytomegalovirus and another virus. After receiving the kidney transplant, the patient was placed on immunosuppressive cyclosporin therapy to prevent rejection of the organ. He returned home, where he was well until seven months later when he developed a fever. By the second week he developed a general growth of the gums which was severe enough to interfere with chewing. The cyclosporin therapy was discontinued. Cytomegalovirus was isolated from his urine, and tests for other viruses were negative. During the third week the patient developed patchy discolorations on the forehead and chest; a biopsy of the skin and gums revealed the presence of Kaposi's sarcoma. Gradual improvement occurred, presumably as a result of the discontinuation of the immunosuppressive therapy. The patient remains well two years later. Samples taken from the biopsy were grown in tissue culture and examined with DNA techniques and electron microscopy. The DNA methods revealed the presence of cytomegalovirus DNA in the cultured cells, and after continued culturing it became possible to isolate intact cytomegalovirus. Electron microscopy revealed two distinct viruses, a larger virus consistent with cytomegalovirus and a smaller one of unknown identity. It is interesting to note that the cultured cells seemed to be a mixture of two types. One type was sufficient to form tumors when injected into mice, but did not contain cytomegalovirus. The other type contained the virus but did not cause tumors in mice. This suggests that the combination of cytomegalovirus infection and immune suppression sets the stage for the development of Kaposi's sarcoma in response to an as yet unidentified virus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Causes of, Transplantation immunology, Cytomegaloviruses, Cytomegalovirus

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Kaposi's sarcoma in Colombia

Article Abstract:

Kaposi's sarcoma is a cancer of the reticuloendothelial cells which form purplish spots on the skin; the cancer can spread to the lymph system and to other organs. The skin lesions often ulcerate and become infected. Patients with altered immune systems, particularly patients with the acquired immunodeficiency syndrome (AIDS), are at risk for Kaposi's sarcoma. The incidence of Kaposi's sarcoma in Latin America, before the onset of the AIDS epidemic, was limited to the classic form of the disease. The health records in Bogota, Colombia from 1935 to 1985 were reviewed to determine the pattern of Kaposi's sarcoma before the AIDS epidemic. The incidence of Kaposi's sarcoma was low, with 79 cases reported during the 50-year period. Seventy-seven appeared in the classic form and two were the result of immunosuppressive cancer drug therapy. The incidence was higher among men over the age of 60 of low socioeconomic status. The disease progressed from the lower limbs and was symmetrical. Diabetes was present in six patients. No other studies in Latin American countries are available for comparison. Kaposi's sarcoma, a chronically progressive disease, was treated with chemotherapy to prolong survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Demographic aspects, Colombia

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