Diagnostic workup of acroangiodermatitis of Mali (pseudo‐Kaposi sarcoma) demasking metastasized epithelioid angiosarcoma

Abstract

A 63-year old man was referred to our outpatient department with an eight-week history of slowly growing, painful skin lesions on his right foot. He also reported a weight loss of 10 kg, occasional fever and excessive spontaneous sweating. He had been experiencing these symptoms for one year. His medical history included arterial hypertension, hyperlipidemia and an operation of an aneurysm of the vena poplitea in his right leg in 2013. Clinical examination revealed blue-to-blackish papules measuring 5-8 mm that were mainly localized on the sole but also on the toes and back of the right foot (Figure 1). The left foot was unremarkable. Phlebological work-up revealed saphenous vein insufficiency of the right lower leg. Histopathology of a skin biopsy showed a dermal capillary proliferation accompanied by a dense infiltrate consisting of lymphocytes, histiocytes and eosinophils and numerous hemosiderin deposits. Most of the vessels were positive for CD31 and negative for D2-40. Immunostaining for human herpesvirus type 8 (HHV-8) was negative, excluding Kaposi sarcoma. Clinicopathological correlation was consistent with a diagnosis of Mali-type acroangiodermatitis. Due to the reported B-symptoms, further diagnostic work-up with abdominal and thoracic computed tomography (CT) was performed, revealing an enlarged, atypical lymph

Pseudo-Kaposi’s Sarcoma: A Rare Case and Review

“…In cases of ulceration or infection, symptomatic treatment is available, and localized small nodules can be treated through freezing or surgery. 14 …”

Kronik Venöz Yetmezlikli Olguda Psödo-Kaposi Sarkomu: Olgu Sunumu

“…Histopatolojisinde kronik doku hipoksisine sekonder kapiller ve fibroblast proliferasyonu, dermal siderofajlar ile Kaposi sarkomuna benzeyebilmektedir ancak vasküler yarıklar, çentikli vasküler yüzey görülmesi, yassı hücreler ve nükleer atipi yokluğu ile Kaposi sarkomundan ayırımı yapılabilmektedir. Histopatolojik ve laboratuvar incelemede HHV-8 negatifliği ve CD34 boyanmanın sadece endotelde görülmesi Kaposi sarkomu tanısından uzaklaştırmaktadır(5,6).…”