Kaposi's sarcoma (KS) appears to develop in association with kidney transplantation, but unlikely with dialysis. We report two cases of classic KS that occurred in patients receiving short-term (less than 3 yr) dialysis. They have been suffering from chronic renal failure due to tuberculosis and diabetes mellitus, respectively. Several to multiple, reddened-violaceous patches, plaques and nodules were found on the hand and the lower extremities. Laboratory studies showed no evidence suggesting immunosuppressed state and there was no history of taking immunosuppressive agents. The biopsies of the two cases revealed proliferation of spindle-shaped cells focally arranged in bundles and multiple dilated vascular spaces outlined by an attenuated endothelium with intravascular and extravasated erythrocytes. The specimens expressed positivity with CD34 antigen. Human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) was detected in one case by polymerase chain reaction method.
Aged ; Case Report ; Herpesvirus, Kaposi Sarcoma-Associated/isolation & purification ; Human ; Kidney Transplantation/adverse effects ; Male ; Middle Age ; Renal Dialysis/adverse effects* ; Sarcoma, Kaposi/virology ; Sarcoma, Kaposi/therapy ; Sarcoma, Kaposi/etiology*

Increased incidences of Kaposi's sarcoma and lymphoid malignancies have been observed in patients with pemphigus, and the human herpesvirus 8 (HHV-8) is very strongly associated with these tumors. Because the virus may be one of the triggering factors of pemphigus, we undertook this study to screen for the presence of HHV-8 in chronic blistering skin diseases including pemphigus. A total of 45 paraffin-embedded specimens were studied using nested polymerase chain reaction (PCR) with primers to amplify a 160-base pair HHV-8 fragment. HHV-8 DNA could be detected in 7 of 9 patients with pemphigus vulagris, and 1 of 2 with pemphigus foliaceus. All specimens of other blistering skin diseases were negative for HHV-8. On sequencing PCR products, the sequences were almost identical with the prototypic sequence for HHV-8, and a few base- pair substitutions at 1086C-T and 1139A-C were detected. The results of our study suggests that HHV-8 might have trophism for pemphigus lesions. Further studies including comparison of HHV-8 DNA load in both lesional and normal skin in the same patient, serological and animal studies would be helpful to study the relationship between HHV-8 and pemphigus.
Adult ; Comparative Study ; DNA Mutational Analysis ; DNA, Viral/genetics ; DNA, Viral/analysis+ACo- ; Female ; Herpesviridae Infections/virology+ACo- ; Herpesviridae Infections/epidemiology ; Herpesvirus, Kaposi Sarcoma-Associated/pathogenicity ; Herpesvirus, Kaposi Sarcoma-Associated/isolation +ACY- purification+ACo- ; Herpesvirus, Kaposi Sarcoma-Associated/genetics ; Human ; Korea/epidemiology ; Male ; Middle Age ; Paraffin Embedding ; Pemphigus/virology+ACo- ; Pemphigus/etiology ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Skin Diseases, Vesiculobullous/virology+ACo- ; Skin Diseases, Viral/virology+ACo- ; Skin Diseases, Viral/epidemiology ; Tissue Fixation

Increased incidences of Kaposi's sarcoma and lymphoid malignancies have been observed in patients with pemphigus, and the human herpesvirus 8 (HHV-8) is very strongly associated with these tumors. Because the virus may be one of the triggering factors of pemphigus, we undertook this study to screen for the presence of HHV-8 in chronic blistering skin diseases including pemphigus. A total of 45 paraffin-embedded specimens were studied using nested polymerase chain reaction (PCR) with primers to amplify a 160-base pair HHV-8 fragment. HHV-8 DNA could be detected in 7 of 9 patients with pemphigus vulagris, and 1 of 2 with pemphigus foliaceus. All specimens of other blistering skin diseases were negative for HHV-8. On sequencing PCR products, the sequences were almost identical with the prototypic sequence for HHV-8, and a few base- pair substitutions at 1086C-T and 1139A-C were detected. The results of our study suggests that HHV-8 might have trophism for pemphigus lesions. Further studies including comparison of HHV-8 DNA load in both lesional and normal skin in the same patient, serological and animal studies would be helpful to study the relationship between HHV-8 and pemphigus.
Adult ; Comparative Study ; DNA Mutational Analysis ; DNA, Viral/genetics ; DNA, Viral/analysis+ACo- ; Female ; Herpesviridae Infections/virology+ACo- ; Herpesviridae Infections/epidemiology ; Herpesvirus, Kaposi Sarcoma-Associated/pathogenicity ; Herpesvirus, Kaposi Sarcoma-Associated/isolation +ACY- purification+ACo- ; Herpesvirus, Kaposi Sarcoma-Associated/genetics ; Human ; Korea/epidemiology ; Male ; Middle Age ; Paraffin Embedding ; Pemphigus/virology+ACo- ; Pemphigus/etiology ; Polymerase Chain Reaction ; Prevalence ; Retrospective Studies ; Skin Diseases, Vesiculobullous/virology+ACo- ; Skin Diseases, Viral/virology+ACo- ; Skin Diseases, Viral/epidemiology ; Tissue Fixation

Castleman's disease represents an atypical lymphoproliferative disorder, infrequently associated with various immunologic abnormalities or subsequent development of malignancy such as Kaposi sarcoma, malignant lymphoma and plasmacytoma. Its clinicopathologic features depend on various etiologic factors such as Kaposi sarcoma herpesvirus (KSHV), oversecretion of IL-6, adhesion molecule and follicular dendritic cell dysplasia, etc. To investigate the relationship of Castleman's disease (CD) and the above factors, we reviewed 22 cases of CD. Four cases of KSHV positive CD were detected, all multicentric, plasma cell type, and these cases displayed prominent vascular proliferation, characteristic 'Kaposi-like lesion'. IL-6 and CD54 positive mononuclear cells were scattered in interfollicular areas of KSHV positive cases. Follicular dendritic cell hyperplasia, vascular proliferation, expression of IL-6 and CD54 did not show any significant difference between solitary vs multicentric type, and plasma cell type vs hyaline vascular type. Our study suggests that KSHV positive CD reveals unique pathologic features, and the probable relationship of KSHV and IL-6 and CD54 is discussed.
Adolescence ; Adult ; Biological Markers ; Dendritic Cells, Follicular/pathology ; Epstein-Barr Virus Infections/virology ; Epstein-Barr Virus Infections/epidemiology ; Female ; Germinal Center/pathology ; Giant Lymph Node Hyperplasia/virology ; Giant Lymph Node Hyperplasia/pathology+ACo- ; Giant Lymph Node Hyperplasia/epidemiology ; Giant Lymph Node Hyperplasia/classification ; Herpesviridae Infections/virology ; Herpesviridae Infections/epidemiology ; Herpesvirus 4, Human/isolation +ACY- purification ; Herpesvirus, Kaposi Sarcoma-Associated/isolation +ACY- purification ; Human ; Hyperplasia ; Intercellular Adhesion Molecule-1/analysis ; Interleukin-6/analysis ; Korea/epidemiology ; Lymph Nodes/virology ; Lymph Nodes/pathology ; Lymph Nodes/chemistry ; Male ; Middle Age ; Neovascularization, Pathologic ; Receptors, Complement 3d/analysis ; Retrospective Studies ; Tumor Virus Infections/virology ; Tumor Virus Infections/epidemiology