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Vol. 5, No. 2, 2011
Issue release date: May – August
Open Access Gateway
Case Rep Gastroenterol 2011;5:416–421
(DOI:10.1159/000330480)

Metastatic Kaposi’s Sarcoma with Perirectal Involvement Diagnosed with Endoscopic Ultrasound-Guided EchoBrush Cytology Sampling

Cornett D.a · Benson M.a · Attia S.b · Weiss J.a · Gopal D.a
aDivision of Gastroenterology and Hepatology and bDivision of Medical Oncology, Department of Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisc., USA
email Corresponding Author

Abstract

AIDS-related Kaposi’s sarcoma (KS) is a low-grade vascular tumor that occurs in association with human herpesvirus 8 infection. Here we report the case of a 21-year-old male with recently diagnosed cutaneous KS who presented with rectal bleeding and anal pruritus. Initial endoscopic evaluation was nondiagnostic. CT imaging showed diffuse lymphadenopathy including perirectal involvement which was suspicious for metastatic KS. Echoendoscopy with needle biopsies and EchoBrush sampling of the lymph nodes revealed spindle cells confirming metastatic KS. Treatment was initiated with liposomal doxorubicin resulting in rapid improvement of the skin lesions. After treatment completion, repeat CT imaging showed improved lymphadenopathy. No further rectal bleeding or perianal pruritus was reported. Although the EchoBrush has previously been used to aid in the diagnosis of pancreatic lesions, this report describes a novel use of EchoBrush to diagnose KS from perirectal lymph nodes.


 Outline


 goto top of outline Key Words

  • Kaposi’s sarcoma
  • Metastasis
  • Human immunodeficiency virus
  • Acquired immunodeficiency
  • Human herpesvirus 8
  • Endoscopic ultrasound
  • EchoBrush

 goto top of outline Abstract

AIDS-related Kaposi’s sarcoma (KS) is a low-grade vascular tumor that occurs in association with human herpesvirus 8 infection. Here we report the case of a 21-year-old male with recently diagnosed cutaneous KS who presented with rectal bleeding and anal pruritus. Initial endoscopic evaluation was nondiagnostic. CT imaging showed diffuse lymphadenopathy including perirectal involvement which was suspicious for metastatic KS. Echoendoscopy with needle biopsies and EchoBrush sampling of the lymph nodes revealed spindle cells confirming metastatic KS. Treatment was initiated with liposomal doxorubicin resulting in rapid improvement of the skin lesions. After treatment completion, repeat CT imaging showed improved lymphadenopathy. No further rectal bleeding or perianal pruritus was reported. Although the EchoBrush has previously been used to aid in the diagnosis of pancreatic lesions, this report describes a novel use of EchoBrush to diagnose KS from perirectal lymph nodes.

Copyright © 2011 S. Karger AG, Basel


 goto top of outline Author Contacts

Deepak Gopal, MD, FRCP(C)
Division of Gastroenterology and Hepatology, University of Wisconsin Medical School4229 Medical Foundation Centennial Building, 1685 Highland Ave
Madison, WI 53705 (USA)
Tel. +1 608 263 7322, E-Mail dvg@medicine.wisc.edu


 goto top of outline Article Information

Published online: July 22, 2011
Number of Print Pages : 6
Number of Figures : 4,


 goto top of outline Publication Details

Case Reports in Gastroenterology

Vol. 5, No. 2, Year 2011 (Cover Date: May - August)

Journal Editor: Urrutia R. (Rochester, Minn.), Lomberk G. (Rochester, Minn.)
ISSN: NIL (Print), eISSN: 1662-0631 (Online)

For additional information: http://www.karger.com/CRG


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

AIDS-related Kaposi’s sarcoma (KS) is a low-grade vascular tumor that occurs in association with human herpesvirus 8 infection. Here we report the case of a 21-year-old male with recently diagnosed cutaneous KS who presented with rectal bleeding and anal pruritus. Initial endoscopic evaluation was nondiagnostic. CT imaging showed diffuse lymphadenopathy including perirectal involvement which was suspicious for metastatic KS. Echoendoscopy with needle biopsies and EchoBrush sampling of the lymph nodes revealed spindle cells confirming metastatic KS. Treatment was initiated with liposomal doxorubicin resulting in rapid improvement of the skin lesions. After treatment completion, repeat CT imaging showed improved lymphadenopathy. No further rectal bleeding or perianal pruritus was reported. Although the EchoBrush has previously been used to aid in the diagnosis of pancreatic lesions, this report describes a novel use of EchoBrush to diagnose KS from perirectal lymph nodes.



 goto top of outline Author Contacts

Deepak Gopal, MD, FRCP(C)
Division of Gastroenterology and Hepatology, University of Wisconsin Medical School4229 Medical Foundation Centennial Building, 1685 Highland Ave
Madison, WI 53705 (USA)
Tel. +1 608 263 7322, E-Mail dvg@medicine.wisc.edu


 goto top of outline Article Information

Published online: July 22, 2011
Number of Print Pages : 6
Number of Figures : 4,


 goto top of outline Publication Details

Case Reports in Gastroenterology

Vol. 5, No. 2, Year 2011 (Cover Date: May - August)

Journal Editor: Urrutia R. (Rochester, Minn.), Lomberk G. (Rochester, Minn.)
ISSN: NIL (Print), eISSN: 1662-0631 (Online)

For additional information: http://www.karger.com/CRG


Open Access License / Drug Dosage

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.