S13C16P14Kaposi-like


S13C16P14-1: The lesion is pan-dermal throughout the reticular dermis. It, in part, is characterized by ill-defined, small, lobular components (“promontories”), some of which are outlined by green arrows. In a second component, that is interstitial, spindle cells form ill-defined traceries among altered collagen bundles of the reticular dermis. The basic patterns are reminiscent of those seen in fibrotic variants of Kaposi’s sarcoma; at this magnification, Kaposi’s sarcoma would appear to be the most appropriate diagnosis.

S13C16P14-2: In this field, the two components are again represented. Small vessels and spindle cells are clustered in the lobular arrays (“promontories”). Among the collagen bundles, spindle cells are irregularly spaced but, focally, the spindle cells partially outline anastomosing, angulated spaces in poorly defined angioendotheliomatous patterns. Again, the patterns are Kaposi’s sarcoma-like.

S13C16P14-3: The two components are again represented but, if the parcels of virtual images, that are an aid in defining a fibrotic variant of Kaposi’s sarcoma, are selected as the measure, the lobular components are unusually prominent.

S13C16P14-4: The endothelial cells of the lobular components (i.e., the so-called promontories) are cytologically atypical; the clusters of atypical cells are poorly channelized. Spindle cells, among the collagen bundles, only partially line some of the angulated spaces; the latter quality also is a feature of fibrotic variants of Kaposi’s sarcoma.

S13C16P14-5: In this field, a transition, from a small, lobular component on the right into the interstitial component of the reticular dermis, is represented. There are scattered, extravasated red blood cells.

The lesion was localized on the chest wall. It has behaved in a locally agressive fashion with several local recurrences, but with no evidence to date of a metastasis. It has been interpreted as a Kaposi’s sarcoma-like, low-grade angiosarcoma (some of the patterns have an angioendotheliomatous quality).

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