A 68-year-old man was referred to our hospital for the treatment of acquired immune deficiency syndrome and pneumocystis pneumonia. Laboratory testing revealed positive results for human immunodeficiency virus (HIV) antibody (Western blot), HIV RNA 4.8×10 copies/mL, human herpesvirus 8 DNA 2.0×102 copies/mL, white-cell count 3,910 /μL, and CD4-positive lymphocyte count 6.8 /μL. He had no gastrointestinal symptoms. Esophagogastroduodenoscopy was performed, as Kaposi's sarcoma was found in his oral cavity (Picture 1). Multiple well-demarcated dark reddish protruded lesions were observed in the gastric corpus (Picture 2), with no findings other than in the gastric corpus. Narrow-band imaging revealed that the intervening part of the gastric gland was dilated with a coarse structure. Although open-type atrophic gastritis was observed, it was able to be differentiated from hyperplastic polyps by its color and surface structure. Biopsy histology revealed the proliferation of CD31- and CD34-positive spindle-shaped cells in the stroma (Picture 3), diagnosed as Kaposi's sarcoma. Combined antiretroviral therapy and liposomal doxorubicin were administered. Esophagogastroduodenoscopy performed nine months after the first visit confirmed the resolution of the protruded lesions in the stomach (Picture 4). Kaposi's sarcoma was not detected in a subsequent biopsy specimen from the reddish scar area. Endoscopic follow-up confirmed no recurrence.
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The authors state that they have no Conflict of Interest (COI).