Kaposi sarcoma arise from
Explanation:
Ans. is ‘b’ i.e.,
Kaposi sarcoma is an intermediate grade, multicentric vascular, tumour
The pathogenesis of Kaposi sarcoma is complex, fundamentally it is an angio proliferative disease that is not a true neoplastic sarcoma.
It is a manifestation of excessive proliferation of spindle cells that are believed to be of vascular origin and have features in common with endothelial and smooth muscle cells.
Grossly → There stages of the disease can be identified
Patch (Ist stage)
Plaque (intermediate stage)
Nodule (last stage)
Histologically - The changes are nonspecific in the early patch stage and more characteristic in the nodular stage which show.
Sheets of plump proliferating spindle cells and endothelial in the dermis or subcutaneous tissue More on Kaposi Sarcoma C/f of Kaposi Sarcoma.
Kaposi sarcoma lesions most commonly appear as raised macules, however, they can also be papular or nodular.
Lesions often appear in the sun-exposed areas, particularly the tip of the nose. Confident lesions may give rise to surrounding lymphedema and may be disfiguring when they involve the face and disabling when they involve the lower extremities.
Apart from skin, Kaposi sarcoma can involve almost any other organ such as lymph nodes, gastrointestinal tract and lung.
In contrast to most malignancies in which lymph node involvement implies metastatic spread and a poor prognosis, lymph node involvement is seen very early in Kaposi sarcoma and is of no special clinical significance.
Management of Kaposi Sarcoma.
Definitive treatment guidelines do not exist for the management of Kaposi sarcoma.
In the majority of cases, effective antiretroviral therapy achieves control. Spontaneous regression has been noted in several cases. Fewer than 10% of AIDS patient with KS die as a consequence of their malignancy. Thus whenever possible one should avoid t/t.
Treatment is indicated under two main circumstances
I. Single lesion or a limited number of lesions are causing significant discomfort or cosmetic problems e.g.
prominent facial lesions, lesions overlying joint or lesions in the oropharynx that cause difficulty in swallowing or breathing, t/t in these cases are Localized radiation Intralesional vinblastine Cryotherapy
II. Patients with large no lesions or in patients with visceral involvement - t/t in these cases
Interferon S is the first choice for single agent systemic therapy for early patients with disseminated disease other drugs which can be used in these cases are Liposomal daunorubicin Liposomal doxorubicin Paclitaxel
Liposomal daunorubicin has been approved as first-line therapy for a patient with advanced KS. Various forms of Kaposi Sarcoma.
There are at least four distinct epidemiological forms of Kaposi sarcoma.
I. Classic form is seen in older men of Mediterranean or Eastern European origin.
No recognized contributing factors (not associated with AIDS)
II. Equatorial African form that occurs in all ages
Without any recognized precipitating factor
II. Kaposi sarcoma associated with organ transplantation and its attendant iatrogenic immuno suppressed state
V. Form associated with HIV -1 infection
Muscles
Connective tissue
Vascular tissue
None of the above