Iatrogenic Kaposi's sarcoma following steroid therapy for nonspecific interstitial pneumonia with HHV-8 genotyping.
We present a case of iatrogenic Kaposi's sarcoma (KS) in a 64-year-old, human immunodeficiency virus (HIV)-negative woman with nonspecific interstitial pneumonia (NSIP) following steroid therapy. She suffered from longstanding exertional dyspnea, and was diagnosed to have NSIP by a thoracoscopic lung biopsy. After 4 months of steroid therapy, multiple purplish nodular or patchy skin lesions developed throughout the entire body. Microscopically, the skin lesions, consisting of closely packed spindle cells forming slit-like vascular structures, were diagnosed as typical KSs. The tumor cells were positive for CD34, factor VIII-related antigen, and human herpesvirus 8 (HHV-8) immunostainings. Using fresh tumor tissue and peripheral blood, polymerase chain reactions revealed the presence of HHV-8. Phylogenetic analysis of HHV-8 ORF K1 genes disclosed that the strain belonged to the subtype II/C and had the M allele at the right-hand side of the genome. To the best of our knowledge, this case report is the first documentation of iatrogenic KS associated with NSIP. A brief review focusing on the HHV-8 genotypes of iatrogenic KS is also presented.
Joo
Mee
M
Department of Pathology, Clinical Research Center, Inje University College of Medicine, Ilsanpaik Hospital, Koyang, Republic of Korea. meejoo@ilsanpak.ac.kr
Soon Lee
Sung
S
Jin Park
Hai
H
Shin
Haeng-Seop
HS
D005260:Female; D019288:Herpesvirus 8, Human / Q000235:genetics; D006801:Humans; D007049:Iatrogenic Disease; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects*; D012514:Sarcoma, Kaposi / Q000139:chemically induced* / Q000473:pathology
D011239:Prednisolone