Three adults with Kaposi's sarcoma of the lymph nodes showed a clinical picture simulating a malignant lymphoma or a granulomatous disease in the absence of characteristic skin lesions. Fever, weight loss, lymphadenopathy, hepatosplenomegaly, anemia, and hypergammaglobulinemia were the presenting features. Monocytes were increased in the blood and plasma cells in the bone marrow.
The occurrence of a nodular pattern suggestive of follicular lymphoma is stressed among the gross findings in the involved lymph nodes. The microscopic features diagnostic of Kaposi's sarcoma consisted of a peripherally located, vascular spindle-celled tissue and of a more centrally placed, nodular, angiomatous proliferation of vascular channels with rare spindle cells. The accompanying, nonspecific lymph node lesions included a highly vascular follicular hyperplasia and an infiltration with plasma cells. The latter findings may lead to an erroneous diagnosis of plasmacytoma or chronic inflammation.
RYWLIN AM, RECHER L, HOFFMAN EP. Lymphoma-like Presentation of Kaposi's Sarcoma: Three Cases Without Characteristic Skin Lesions. Arch Dermatol. 1966;93(5):554–561. doi:10.1001/archderm.1966.01600230058018
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