Kaposha's sarcoma
Contents:
Description:
Kaposha's sarcoma - the multifocal disease of the tumoral nature affecting generally skin, mucous membranes of an oral cavity, digestive tract, lymph nodes. The disease was for the first time described M. Kaposha in 1872 under the name "idiopathic multiple sarcoma", and then - "idiopathic multiple hemorrhagic sarcoma of skin".
Symptoms of Sarcoma of Kaposha:
On hands and legs, is more often to areas, stop and shins, there are spots of bluish-violet color which infiltrirutsya gradually, forming round or oval disks, nodes with the shelled surface. Sometimes at the beginning of a disease there are papules reminding rashes at red flat herpes. Gradually tumors reach the sizes forest or walnut. They are plotnovata, are elastic or testovata are, as a rule, penetrated by teleangiectasias and can be followed by pains (especially when pressing). Then nodes can resolve, leaving the pigmented impressions reminding hems. At a chronic current the disease proceeds for years. However in several years dissimination of nodes, a hyperadenosis, elephantiasis of extremities can be observed, transformation in a true sarcomatosis with metastasises in bones, lungs, a liver, etc. is possible. In these cases temperature increases, appear a pneumorrhagia, a bloody diarrhea, there come the cachexia and a lethal outcome.
Classification of sarcoma of Kaposha:
* Classical type
* Local type
* Epidemic type
* Immune супрессивный type
Classical type. It is widespread in Central Europe, Russia and Italy. Favourite localizations of sarcoma of Kaposha of classical type are feet, the side surfaces of a shin, a surface of brushes. Very seldom on mucous membranes and centuries. The centers of defeat are usually symmetric, asimptomna, but can seldom be an itch and burning. Borders of the centers, as a rule, accurate.
Distinguish 3 clinical stages:
1. Spotty. The earliest stage. Spots at this stage of reddish and cyanotic or reddish-brown color with a diameter from 1 mm to 5 mm, irregular shape. the surface is smooth.
2. Papular. Elements in this stage of a spherical or hemispherical shape, a dense and elastic consistence, from 2 mm to 1 cm in the diameter. More often isolated. At merge form plaques of the flattened or semi-spherical shape. A surface of plaques smooth or rough (as orange-peels).
3. Tumoral. At this stage there is a formation of single or multiple nodes. Diameter from the 1-5th, red and cyanotic or cyanotic-brown color. Soft or a dense and elastic consistence, merging and ulcerating.
Local type. It is widespread, generally among inhabitants of the Central Africa. Begins preferential at children's age, the peak of incidence falls on the first year of life of the child. As a rule, internals and the main lymph nodes are surprised. Skin defeats are rare and minimum.
Epidemic type. This sarcoma of Kaposha associated with AIDS is the most reliable symptom of HIV infection. The age, brightness of coloring and juiciness of vysypny elements is characteristic young (up to 37 years). Also localization of tumors is unusual: on a tip of a nose and mucous membranes, on a hard palate and upper extremities. The disease rapid current with obligatory involvement of lymph nodes and internals is noted.
Immune супрессивный type. Proceeds, as a rule, chronically and it is good-quality. Develops after renal transplantation after which special types of immunosuppressors are appointed. At cancellation of drugs there occurs regress of a disease. Internals are involved seldom.
Allocate acute, subacute and chronic forms of sarcoma of Kaposha.
The acute form of sarcoma of Kaposha is distinguished by bystry generalization of process. The accruing symptoms of the general intoxication and a cachexia serve as a cause of death within 2 months-2 of years.
The subacute form of sarcoma of Kaposha has less bystry and not so malignant current. Disease duration without treatment can reach 2-3 years. The chronic form of sarcoma of Kaposha at which the dliitelnost of a disease can make 8-10 years and more differs in rather high-quality course, gradual progressing of process.
Reasons of Sarcoma of Kaposha:
It is accepted to carry a virus of herpes of the 8th type (HHV-8, VGCh-8) to the factors provoking development of sarcoma of Kaposha. Treat risk groups on development of sarcoma of Kaposha:
* HIV-positive men, especially homosexuals.
* Elderly men of the Mediterranean origin.
* Persons from the equatorial Africa.
* Persons with transplanted organs (recipients).
Treatment of Sarcoma of Kaposha:
Local therapy includes beam methods, cryotherapy, injections in a tumor of chemotherapeutic drugs, applications with dinitrobenzene chloride, injections in an interferon tumor an alpha and some other methods. The main indications for radiation are the large or painful centers, and also attempt to achieve cosmetic effect. Treatment of sarcoma of Kaposha can sometimes be followed by a fabric ulceration that is very dangerous because of a possibility of infection against the background of an immunodeficiency.
System treatment of sarcoma of Kaposha perhaps in the presence immunological advantage factors (for example, a large number of CD4 of cells) against the background of the asymptomatic course of a disease. In this case chances of treatment increase. But patients with the bad forecast of a disease can be also considered as candidates for treatment. In this case the system polychemotherapy or palliative monochemotherapy is carried out. Danger of use of polychemotherapy at an immunodeficiency is connected with toxic influence of himiopreparat on marrow, especially against the background of the drugs used for treatment of HIV infection.
