The lesions from the 8 patients with AIDS-KS were also localised in areas other than the lower limbs (Figure 2). All of the lesions studied by ultrasound appeared to be localized between the epidermis and the dermis, although in some cases they were also subcutaneous ( Figure 3, 4). Figure 1 Lesion of Classic KS. Protruding erythemal-cyanotic nodule, with slow evolution, in a patient with Classic Kaposi
Sarcoma. Figure 2 Lesion of AIDS-KS. Rapidly growing nodule, in a patient with AIDS-KS and severe immunodeficiency. Figure 3 Histology of Classic Kaposi Sarcoma (hematoxylin and eosin, 4X). Evident nodular proliferation of spindle cells, with hyperchromic nuclei www.selleckchem.com/products/chir-98014.html and rare mitotic figures; presence of multiple, small, diffused and morphologically irregular vascular spaces. Figure 4 Ultrasound image of a nodule in a patient with Classic Kaposi Sarcoma. The formation is homogeneous, hypoechoic, with clear and well-defined contours. It involves the epidermis and derma and it is associated to ectasia of local-regional vessels in adipose sub-cutaneous tissue. According to the ultrasound, in 15 of the 16 patients with CKS,
the lesions, whether plaque-like or Cytoskeletal Signaling inhibitor nodular, appeared to be solid and homogeneously hypoechoic, whereas in 3 of the 8 patients with AIDS-KS, the lesions were hypoechoic yet dishomogeneous (Table 1). According to the color power Doppler, in 6 of the 8 patients with AIDS-KS (75%), there were internal signals (Figure 5). In three of these patients, the signals were evident (Figure 6); in two of them they were present in at least 50% of the region of interest (ROI); in the remaining patient it was not possible to accurately evaluate the signal, because of the presence of considerable find more calcification and fibrosis. Only in 2 (16%) of the Parvulin patients with CKS was there a color power Doppler signal. Figure 5 Vascular aspects of Classic KS. Classic Kaposi Sarcoma lesion, with slight vascularisation (only one vascular pole), in a small superficial hypoechoic lesion, is evident. Figure 6 Vascular aspects of AIDS-KS. AIDS-KS lesion, with
evident vascularisation; the monochromatic color power Doppler indicates marked vascularisation of the periphery of the nodule, with a ring-like pattern and a hypovascular central area. According to the ultrasound, in all patients the contours of the lesions were regular, also in depth. Histologically, all of the lesions showed vascular proliferation, consisting of irregularly dilated canals, which to varying degrees were associated with bundles of spindle cells. These cells delimited irregular vascular spaces, present in the derma, at various levels, in a nodular or plaque-like state. In some patients there were telangiectasias which extended to the subcutaneous layer and which were more evident in larger lesions.