Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1986 Jul;39(7):742–749. doi: 10.1136/jcp.39.7.742

Histogenesis of Kaposi's sarcoma in patients with and without acquired immune deficiency syndrome (AIDS).

R R Jones, J Spaull, C Spry, E W Jones
PMCID: PMC500035  PMID: 3090109

Abstract

Immunohistochemical studies were performed in thirty skin biopsies from patients with Kaposi's sarcoma, who did and did not have the acquired immune deficiency syndrome (AIDS). Tumour histogenesis was rigorously tested using a battery of endothelial cell markers, which included two new monoclonal antibodies, EN4 and PAL E. These are both specific for endothelial cells and can be visualised in appropriately fixed paraffin embedded tissue. Whereas EN4 labels all endothelial cells, PAL E is negative in endothelium of lymphatic derivation. Lectin binding with Ulex europaeus agglutinin 1 (UEA-1) and the presence of factor VIII related antigen (FVIIIRA) and laminin were also examined. In nodular lesions of Kaposi's sarcoma the spindle cell areas were positive with EN4 and UEA-1, negative with PAL E, and showed focal staining for FVIIIRA and laminin. These results confirm that the tumour is of endothelial cell origin. Six patch stage lesions showed a network of angulated spaces, lined by cells that were positive with EN4 and UEA-1, negative with PAL E and anti-FVIIIRA, and showed only weak staining for laminin. This pattern was observed in both AIDS and non-AIDS related cases and strongly favours a lymphatic derivation for the tumour. This has important implications as it suggests that lymphatic endothelium may have special characteristics that lead to neoplastic transformation in patients with retrovirus infection.

Full text

PDF
744

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barsky S. H., Baker A., Siegal G. P., Togo S., Liotta L. A. Use of anti-basement membrane antibodies to distinguish blood vessel capillaries from lymphatic capillaries. Am J Surg Pathol. 1983 Oct;7(7):667–677. doi: 10.1097/00000478-198310000-00007. [DOI] [PubMed] [Google Scholar]
  2. Blumenfeld W., Wagar E., Hadley W. K. Use of the transbronchial biopsy for diagnosis of opportunistic pulmonary infections in acquired immunodeficiency syndrome (AIDS). Am J Clin Pathol. 1984 Jan;81(1):1–5. doi: 10.1093/ajcp/81.1.1. [DOI] [PubMed] [Google Scholar]
  3. Burgdorf W. H., Mukai K., Rosai J. Immunohistochemical identification of factor VIII-related antigen in endothelial cells of cutaneous lesions of alleged vascular nature. Am J Clin Pathol. 1981 Feb;75(2):167–171. doi: 10.1093/ajcp/75.2.167. [DOI] [PubMed] [Google Scholar]
  4. COX F. H., HELWIG E. B. Kaposi's sarcoma. Cancer. 1959 Mar-Apr;12(2):289–298. doi: 10.1002/1097-0142(195903/04)12:2<289::aid-cncr2820120213>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  5. Collings L. A., Poulter L. W., Janossy G. The demonstration of cell surface antigens on T cells, B cells and accessory cells in paraffin-embedded human tissues. J Immunol Methods. 1984 Dec 31;75(2):227–239. doi: 10.1016/0022-1759(84)90106-6. [DOI] [PubMed] [Google Scholar]
  6. Cui Y. C., Tai P. C., Gatter K. C., Mason D. Y., Spry C. J. A vascular endothelial cell antigen with restricted distribution in human foetal, adult and malignant tissues. Immunology. 1983 May;49(1):183–189. [PMC free article] [PubMed] [Google Scholar]
  7. Gange R. W., Jones E. W. Kaposi's sarcoma and immunosuppressive therapy: an appraisal. Clin Exp Dermatol. 1978 Jun;3(2):135–146. doi: 10.1111/j.1365-2230.1978.tb01477.x. [DOI] [PubMed] [Google Scholar]
  8. Gange R. W., Jones E. W. Lymphangioma-like Kaposi's sarcoma. A report of three cases. Br J Dermatol. 1979 Mar;100(3):327–334. doi: 10.1111/j.1365-2133.1979.tb06207.x. [DOI] [PubMed] [Google Scholar]
  9. Guarda L. G., Silva E. G., Ordóez N. G., Smith J. L., Jr Factor VIII in Kaposi's sarcoma. Am J Clin Pathol. 1981 Aug;76(2):197–200. doi: 10.1093/ajcp/76.2.197. [DOI] [PubMed] [Google Scholar]
  10. Harwood A. R., Osoba D., Hofstader S. L., Goldstein M. B., Cardella C. J., Holecek M. J., Kunynetz R., Giammarco R. A. Kaposi's sarcoma in recipients of renal transplants. Am J Med. 1979 Nov;67(5):759–765. doi: 10.1016/0002-9343(79)90731-9. [DOI] [PubMed] [Google Scholar]
  11. Hoshaw R. A., Schwartz R. A. Kaposi's sarcoma after immunosuppressive therapy with prednisone. Arch Dermatol. 1980 Nov;116(11):1280–1282. [PubMed] [Google Scholar]
  12. Jones E. W. Dowling oration 1976. Malignant vascular tumours. Clin Exp Dermatol. 1976 Dec;1(4):287–312. doi: 10.1111/j.1365-2230.1976.tb01435.x. [DOI] [PubMed] [Google Scholar]
  13. McNutt N. S., Fletcher V., Conant M. A. Early lesions of Kaposi's sarcoma in homosexual men. An ultrastructural comparison with other vascular proliferations in skin. Am J Pathol. 1983 Apr;111(1):62–77. [PMC free article] [PubMed] [Google Scholar]
  14. Millard P. R., Heryet A. R. An immunohistological study of factor VIII related antigen and Kaposi's sarcoma using polyclonal and monoclonal antibodies. J Pathol. 1985 May;146(1):31–38. doi: 10.1002/path.1711460104. [DOI] [PubMed] [Google Scholar]
  15. Mitchell D., Ibrahim S., Gusterson B. A. Improved immunohistochemical localization of tissue antigens using modified methacarn fixation. J Histochem Cytochem. 1985 May;33(5):491–495. doi: 10.1177/33.5.3921605. [DOI] [PubMed] [Google Scholar]
  16. Mortimer P. S., Cherry G. W., Jones R. L., Barnhill R. L., Ryan T. J. The importance of elastic fibres in skin lymphatics. Br J Dermatol. 1983 May;108(5):561–566. doi: 10.1111/j.1365-2133.1983.tb01057.x. [DOI] [PubMed] [Google Scholar]
  17. Nadji M., Morales A. R., Ziegles-Weissman J., Penneys N. S. Kaposi's sarcoma: immunohistologic evidence for an endothelial origin. Arch Pathol Lab Med. 1981 May;105(5):274–275. [PubMed] [Google Scholar]
  18. Ordóez N. G., Batsakis J. G. Comparison of Ulex europaeus I lectin and factor VIII-related antigen in vascular lesions. Arch Pathol Lab Med. 1984 Feb;108(2):129–132. [PubMed] [Google Scholar]
  19. Schlingemann R. O., Dingjan G. M., Emeis J. J., Blok J., Warnaar S. O., Ruiter D. J. Monoclonal antibody PAL-E specific for endothelium. Lab Invest. 1985 Jan;52(1):71–76. [PubMed] [Google Scholar]
  20. Templeton A. C. Studies in Kaposi's sarcoma. Postmortem findings and disease patterns in women. Cancer. 1972 Sep;30(3):854–867. doi: 10.1002/1097-0142(197209)30:3<854::aid-cncr2820300337>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  21. Walker R. A. Ulex europeus I--peroxidase as a marker of vascular endothelium: its application in routine histopathology. J Pathol. 1985 Jun;146(2):123–127. doi: 10.1002/path.1711460207. [DOI] [PubMed] [Google Scholar]
  22. Williams G. The pleural reaction to injury: a histological and electron-optical study with special reference to elastic-tissue formation. J Pathol. 1970 Jan;100(1):1–7. doi: 10.1002/path.1711000102. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES