Letter to the Editor

Proposed Clinical and Endoscopic Predictors for Diagnosis of Gastrointestinal Kaposi Sarcoma

Authors: Mitchell S. Cappell, MD, PhD, Borko Nojkov, MD, Mitual Amin, MD

Abstract

To the Editor: Gastrointestinal Kaposi sarcoma (KS) is often missed by superficial endoscopic biopsies because of its submucosal location. For example, among 30 patients undergoing gastrointestinal endoscopy with biopsy, the diagnosis was missed in 77% of biopsied lesions in a study published in 19851; among the first 26 patients undergoing gastrointestinal endoscopy with biopsies, the diagnosis was missed in 80% of patients in a study published in 19952; and among 24 patients undergoing gastrointestinal endoscopy with biopsy, the diagnosis was missed in 35% of 116 lesions biopsied in a study published in 2012.3 Clinicoendoscopic predictors for gastrointestinal KS would be useful in decision making by endoscopists whether to perform multiple, deep, endoscopic biopsies to improve the sensitivity of detecting this submucosal lesion and in decision making by pathologists whether to perform special, diagnostic, immunohistochemical stains, such as for human herpesvirus-8 (HHV-8).4 This diagnosis is becoming increasingly important because of greatly improved therapy.5 We report multifarious gastrointestinal symptoms caused by gastrointestinal KS and propose systematic clinicoendoscopic predictors for suspected gastrointestinal KS based on literature review.

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