Lymph nodes & spleen, nonlymphoid
Lymph nodes-vascular lesions
Kaposi sarcoma

Topic Completed: 1 June 2006

Minor changes: 10 August 2020

Copyright: 2003-2020,, Inc.

PubMed Search: Kaposi sarcoma[TI] lymph node

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Cite this page: DePond W. Kaposi sarcoma. website. Accessed September 28th, 2020.
Definition / general
  • Difficult to detect early involvement; often best diagnosis is atypical vascular proliferation suggestive of early Kaposi sarcoma
  • May coexist with leukemia, lymphoma, Castleman disease or mycobacterial spindle cell tumor (Am J Surg Pathol 1999;23:656)
  • Classic form: elderly men of Jewish or Mediterranean descent; skin lesions of lower extremities with only rare nodal involvement; indolent for 10 - 15 years, then systemic lesions or lymphoreticular malignancies
  • African (endemic) form: young adults, usually men with indolent skin involvement, progressive large exophytic or deeply invasive tumors or occasional regional nodal involvement
  • Childhood form: children 2 - 13 years, usually boys, HIV negative with lymphadenopathy but usually no skin lesions; death within 1 - 3 years
  • HIV associated: usually homosexual men, often disseminated involving mucocutaneous sites, lymph nodes, GI tract and lungs
  • Transplant associated: local or systemic (Transplant Proc 2004;36:2145, Transplant Proc 2005;37:967)
Case reports
Gross description
  • Often multifocal
Microscopic (histologic) description
  • Resembles skin tumors
  • Curved fascicles of spindle cells separated by slit-like vascular spaces with extravasated red blood cells and frequent mitotic figures
  • Spindle cells have pale cytoplasm, elongated nuclei, indistinct nucleoli; often individual cell necrosis
  • Initially subcapsular but extends throughout node and into perinodal tissue
  • Almost always has PAS+ diastase resistant, PTAH+ hyaline globules
  • May have accompanying lymphocytes, plasma cells, histiocytes and immunoblasts, hemosiderin deposits
  • May resemble Castleman disease
Microscopic (histologic) images

Case #307



Images hosted on other servers:

Peripheral tumor deposits

Well circumscribed tumor nodule

Well circumscribed
tumor and adjacent
follicular hyperplasia

Well circumscribed
tumor with adjacent
sinus histiocytosis

Interlacing bundles of
spindle cells separated
by vascular slits containing
extravasated red blood cells

Extreme vascularity
with dilated and
blood filled channels

Predominantly sinusoidal
spread of tumor surrounding
follicles with hyperplastic
germinal centers

Tumor (arrow) extends
along sinusoids towards
reactive follicles

Kaposi sarcoma (upper right),
lymphoma (lower left) and
plasma cells (arrow)

PAS+ hyaline globules

CD34 highlights vessels

Cytology images

Case #307

Various images

Positive stains
Negative stains
Molecular / cytogenetics description
Additional references
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