Oral Kaposi's sarcoma in Tanzania: presentation, immunopathology and human herpesvirus-8 association.
Oral Kaposi's sarcoma (OKS) from Tanzanian patients (78) at Muhimbili National Hospital/Muhimbili University College of Health Sciences corresponding to approximately 10% of KS registered during 1990-2005, were diagnosed (ELISA) as HIV-infected (OAKS) (74/78) and endemic KS (4/78). Females were 69.2% (54/78) with median age 31 and males 30.8% (24/78) with median age 38. More males (50%) had systemic KS than females (37%) and 4-times more multicentric OKS. All tested (34) oral KS patients sera had HHV-8 antibodies. Available (31/78) blood showed very low CD4+ T-lymphocyte counts. Most OKS (61.5%) had nodular histology. Immunostaining showed adult male nodular OAKS to have a significantly higher frequency of viral LANA+, endothelial CD34+ tumour spindle-cells (SC) and more Ki-67+ (median =24.1%) proliferating cells compared to females (17.2%). Juvenile nodular OAKS had more LANA+ and Ki-67+ cells than corresponding adult cases. Significantly more LANA+ and Ki-67+ cells were found in nodular OAKS compared to cutaneous HIV/AIDS Kaposi's sarcoma (CAKS). A positive correlation (60%) was found between the proliferation index (Ki-67+ cell frequency) and LANA+/CD34+ SC. OKS in Tanzania is since 1990, mostly seen in females, associated with HIV/AIDS and advanced (nodular) histopathology. Males have more systemic tumour burden while more females develop primary OAKS. HHV-8+ cells were more frequent in nodular male than female and in juvenile than adult nodular OAKS than cAKS. Higher tumoral HHV-8 content appeared to be correlated to proliferation index.
Mwakigonja
Amos R
AR
Immunopathology Laboratory, Department of Oncology-Pathology, Cancer Centrum Karolinska, R8:00, Karolinska Hospital/Institute, S-171 76 Stockholm, Sweden. amos.r.mwakigonja@ki.se
Pak
Fatemeh
F
Pyakurel
Pawan
P
Mosha
Innocent J
IJ
Urassa
Willy K
WK
Kaaya
Ephata E
EE
Biberfeld
Peter
P
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D018952:Antigens, CD34 / Q000032:analysis; D000956:Antigens, Viral / Q000032:analysis; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D019288:Herpesvirus 8, Human / Q000302:isolation & purification*; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D009687:Nuclear Proteins / Q000032:analysis; D012514:Sarcoma, Kaposi / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D013636:Tanzania
D000914:Antibodies, Viral; D018952:Antigens, CD34; D000956:Antigens, Viral; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; C109540:latency-associated nuclear antigen