Disseminated Kaposi Sarcoma Associated With Cytomegalovirus Proctitis in People Living With Human Immunodeficiency Virus (PLHIV): A Major Diagnostic Dilemma

Rodrigo Portella; Cesar Cilento Ponce; Rosely Antunes Patzina; Jose C Ardengh; Richard Calanca

doi:10.7759/cureus.42039

Disseminated Kaposi Sarcoma Associated With Cytomegalovirus Proctitis in People Living With Human Immunodeficiency Virus (PLHIV): A Major Diagnostic Dilemma

Cureus. 2023 Jul 17;15(7):e42039. doi: 10.7759/cureus.42039. eCollection 2023 Jul.

Authors

Rodrigo Portella¹, Cesar Cilento Ponce², Rosely Antunes Patzina^{3

4}, Jose C Ardengh^{5

6

7}, Richard Calanca⁸

Affiliations

¹ Infectious Diseases, Instituto de Infectologia Emílio Ribas, São Paulo, BRA.
² Pathology, Instituto de infectologia Emílio Ribas, São Paulo, BRA.
³ Pathology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRA.
⁴ Pathology, Instituto de Infectologia Emílio Ribas, São Paulo, BRA.
⁵ Gastrointestinal Endoscopy, Hospital das Clínicas de Ribeirão Preto, Ribeirão Preto, BRA.
⁶ Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, BRA.
⁷ Digestive Endoscopy, Instituto de Infectologia Emílio Ribas, São Paulo, BRA.
⁸ Digestive Endoscopy, Instituto de Infectologia Emilio Ribas, São Paulo, BRA.

Abstract

Kaposi sarcoma (KS) is a vascular tumor of low malignancy. Lesions may vary in shape, color, and size. Angiogenesis, spindle-shaped cells, and inflammatory infiltration are the main histologic features of the condition. Human herpesvirus-8 (HHV-8) infection and immune dysfunction play a key role in the development of KS. We report a case of a 40-year-old man with disseminated KS (DKS) who underwent an endoscopic examination. Colonoscopy revealed an ulcer in the anal canal. Biopsy and immunohistochemistry (IHC) confirmed the diagnosis of cytomegalovirus (CMV) proctitis, a rare and underreported pathology.

Keywords: clinical pathology; cytomegalo virus (cmv); disseminated kaposi sarcoma; gastrointestinal manifestations; hiv; image enhanced endoscopy; immuno-histochemical; treatment.

Publication types

Case Reports