1984 Volume 23 Issue 3 Pages 415-420
A case of recurrent Kaposi's sarcoma in the left lateral malleolus was reported. This 67 y.o. female had the left lateral malleolus tumor resected 12 years ago. Pathological diagnosis of “hemangiosarcoma” was obtained. Since then tumor resections of the same site were performed several times. The lastresected tumor tissue was examined cytologically, histologically, and immunohistochemically. Resected tumor tissue was 10×12 cm and macroscopic appearance was dark red, coarse irregular surface with several ulcerations. The microscopic examination revealed massive and invasive proliferation of atypical fusiform cells in the full thickness of the dermis. They had the characteristic vascular slits and channels with red blood cells. Hemosiderin-laden macrophages were numerous, indicating recurrent hemorrhage. Some of the tumor cells were stained positively for the factor VII-related antigen using immunohistochemical PAP method. Papanicolaou's stain on the imprinted smear of the tumor tissue revealed as follows ; many of the tumor cells were spindle or fibrous form with a few round form. The cytoplasm was stained light-green and cytoplasmic borders were ill-defined. Nuclei were round or elliptic usually with one or two nucleoli. Their nuclear rims were sharp and evenly thick. Pleomorphism was poor in cytoplasm and nuclei, and mitotic figures were rare. PAS-positive inclusion bodies were found in some of the tumor cytoplasm. From the cytodiagnostic view, differentiation of Kaposi's sarcoma from other closely-related tumors as difficult, but based on clinical course, pathological findings and immunohistochemical method, its diagnosis was easy.
