Diagnosis of Kaposi Sarcoma
The following tests and procedures may be used to diagnose Kaposi sarcoma:
- Physical exam and history: An exam of the body to check general signs of health, including checking skin and lymph nodes for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body. This is used to find Kaposi sarcoma in the lungs.
- Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an incision in the skin or opening in the body, such as the mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease. This is used to find Kaposi sarcoma lesions in the gastrointestinal tract.
- Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Cancer spreads in the body through tissue, the lymph system and through blood. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options for Kaposi sarcoma
depend on the following:
- The type of Kaposi sarcoma.
- The general health of the patient, especially the immune system.
- Whether the cancer has spread.
- Whether the cancer has just been diagnosed or has recurred (come back).
Classic Kaposi Sarcoma
Classic Kaposi sarcoma is found most often in older men of Italian or Eastern European Jewish origin. Classic Kaposi sarcoma is a rare disease that gets worse slowly over many years.
Symptoms of classic Kaposi sarcoma may include slow-growing lesions on the legs and feet. Patients may have one or more red, purple, or brown skin lesions on the legs and feet, most often on the ankles or soles of the feet. Over time, lesions may form in other parts of the body, such as the stomach, intestines, or lymph nodes. The lesions usually don’t cause any symptoms, but may grow in size and number over a period of 10 years or more. Pressure from the lesions may block the flow of lymph and blood in the legs and cause painful swelling. Lesions in the digestive tract may cause gastrointestinal bleeding.
Some patients with classic Kaposi sarcoma may develop another type of cancer before the Kaposi sarcoma lesions appear or later in life. Most often, this second cancer is non-Hodgkin lymphoma. Frequent follow-up is needed to watch for these second cancers.
African Kaposi Sarcoma
African Kaposi sarcoma is a fairly common form of the disease found in young adult males who live near the equator in Africa. Symptoms of African Kaposi sarcoma can be the same as classic Kaposi sarcoma. However, African Kaposi sarcoma can also be found in a much more aggressive form that may cause sores on the skin and spread from the skin to the tissues to the bone. Another form of Kaposi sarcoma that is common in young children in Africa does not affect the skin but spreads through the lymph nodes to vital organs, and quickly becomes fatal.
This type of Kaposi sarcoma is not common in the United States.
Immunosuppressive Treatment-related Kaposi Sarcoma
Immunosuppressive treatment-related Kaposi sarcoma is found in patients who have had an organ transplant (for example, a kidney, heart, or liver transplant). These patients take drugs to keep their immune systems from attacking the new organ. When the body’s immune system is weakened by these drugs, diseases like Kaposi sarcoma can develop.
Immunosuppressive treatment-related Kaposi sarcoma often affects only the skin, but may also occur in the mucous membranes or other organs.
This type of Kaposi sarcoma is also called transplant-related or acquired Kaposi sarcoma.
Epidemic Kaposi Sarcoma
Epidemic Kaposi sarcoma is found in patients who have acquired immunodeficiency syndrome (AIDS).
AIDS is caused by the human immunodeficiency virus (HIV), which attacks and weakens the immune system. When the body’s immune system is weakened by HIV, infections and cancers like Kaposi sarcoma can develop.
Most cases of epidemic Kaposi sarcoma in the United States have been diagnosed in homosexual or bisexual men with HIV infection.
Symptoms of epidemic Kaposi sarcoma include lesions on different parts of the body, including any of the following:
- Lining of the mouth.
- Lymph nodes.
- Stomach and intestines.
- Lungs and lining of the chest.
Kaposi sarcoma is sometimes found in the lining of the mouth during a regular dental check-up.
In most patients with epidemic Kaposi sarcoma, the disease will spread to other parts of the body over time. Fever, weight loss, or diarrhea can occur. In the later stages of epidemic Kaposi sarcoma, life-threatening infections are common.
The use of drug therapy called HAART reduces the risk of epidemic Kaposi sarcoma in HIV-infected patients.
HAART (highly active antiretroviral therapy) is a combination of several drugs that block HIV and slow down the development of AIDS and AIDS-related Kaposi sarcoma. For information about AIDS and its treatment, see the AIDSinfo Web site.
Nonepidemic Gay-related Kaposi Sarcoma
There is a type of nonepidemic Kaposi sarcoma that develops in homosexual men who have no signs or symptoms of HIV infection. This type of Kaposi sarcoma progresses slowly, with new lesions appearing every few years. The lesions are most common on the arms, legs, and genitals, but can develop anywhere on the skin.
If you have symptoms associated with Kaposi sarcoma, contact us to request an appointment with our oncology specialists to begin diagnostic testing.