Unusual Manifestations of Gastrointestinal Kaposi's Sarcoma in Acquired Immunodeficiency Syndrome

To the Editor.—  Kaposi's sarcoma of the gastrointestinal tract in patients with acquired immunodeficiency syndrome (AIDS) is usually asymptomatic.¹ In contrast, we describe two patients with unusual clinical manifestations of this tumor.Top, Portion of intestinal perforation in right upper corner and focus of Kaposi's sarcoma in center (hematoxylin-eosin, ×30). Bottom, Irregular slitlike vascular channels separated by fibroblastic stroma characteristic of Kaposi's sarcoma (hematoxylin-eosin, ×320).

Report of Cases.—Case 1.—  A 34-year-old homosexual man presented with AIDS manifested by oral and cutaneous Kaposi's sarcoma. He was treated initially with interleukin-2 with progression of his skin lesions. Bronchoscopy performed eight months after presentation revealed pulmonary involvement with Kaposi's sarcoma. Therapy with bleomycin sulfate and vincristine sulfate was initiated with partial response.Five months after initiation of chemotherapy, the patient entered the hospital with sepsis secondary to ileal perforation. He underwent emergency laparotomy and small-bowel resection. The resected segment of small intestine