{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:31:34Z","timestamp":1790238694056,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2006,7,10]],"date-time":"2006-07-10T00:00:00Z","timestamp":1152489600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Advanced Kaposi's sarcoma is frequently associated with chronic lymphedema (cLO). The histopathological features of lymphedematous HIV\u2010associated KS (KS) are poorly documented and the co\u2010existence of fibroma\u2010like nodules in lymphedematous KS is under\u2010recognized. The aims of this study were to assess the clinicopathological spectrum and diagnostic difficulties associated with lymphedematous KS and to highlight the clinicopathological profile of fibroma\u2010like nodules. In addition, the pathogenesis of fibroma\u2010like nodules and cLO is revisited.<\/jats:p><jats:p><jats:bold>Materials and methods:\u2002<\/jats:bold> Prospective 17\u2010month clinicopathological study of all biopsies from patients with lymphedematous KS.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Seventy\u2010four biopsies, the majority from the lower limbs, from 41 patients were evaluated. Nineteen, 14, five and three patients had one, two, three or four biopsies each, respectively. In 14 biopsies, there was poor clinicopathological correlation of KS stage. Exclusive lesional KS (patch, plaque, nodule or lymphangioma\u2010like) was identified in 29 biopsies; 23 and eight biopsies demonstrated KS or fibroma\u2010like morphology and the adjacent dermis demonstrated cLO. There was variable intratumoral and peritumoral venous compression and lymphatic dilatation. Fourteen biopsies demonstrated cLO exclusively. Smaller fibroma\u2010like nodules lacked KS spindle cells, whereas &gt;5\u2003mm nodules demonstrated focal KS spindle cell proliferation and aggregation on extensive sectioning. The subcutis of 42 biopsies demonstrated variable fibrosis, hemosiderin deposits, lymphocytes, plasma cells, KS, interstitial granular material and pools of lymph fluid. Subcutaneous abscesses were identified in six biopsies. All biopsies had variable epidermal features of cLO.<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> cLO influences clinicopathological correlation of KS stage and may also mask the presence of KS and the co\u2010existence of subcutaneous abscesses. Smaller fibroma\u2010like nodules are hypothesized to be a manifestation of cLO that have the potential to acquire the characteristics of KS. Lymphatic and venous obstruction, protein\u2010rich interstitial fluid, tissue hemosiderin and subcutaneous infection are hypothesized to play a combined role in the evolution and perpetuation of cLO.<\/jats:p>","DOI":"10.1111\/j.1600-0560.2006.00352.x","type":"journal-article","created":{"date-parts":[[2006,7,10]],"date-time":"2006-07-10T18:10:30Z","timestamp":1152555030000},"page":"474-481","source":"Crossref","is-referenced-by-count":21,"title":["Lymphedematous HIV\u2010associated Kaposi's sarcoma"],"prefix":"10.1111","volume":"33","author":[{"given":"Pratistadevi K.","family":"Ramdial","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runjan","family":"Chetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhugwan","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendrakumar","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamila","family":"Aboobaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,10]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"183","article-title":"Lymphedema and Kaposi's sarcoma: How and why?","volume":"2","author":"Mugoni MG","year":"1994","journal-title":"J Geriatr Dermatol"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199110000-00011"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03364.x"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/17843286.1994.11718358"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(95)70114-1"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000246731"},{"key":"e_1_2_5_8_2","first-page":"490","article-title":"Pre\u2010Kaposi's sarcoma: an expansion of the spectrum of Kaposi's sarcoma lesions","volume":"9","author":"Simonart T","year":"1999","journal-title":"Eur J Dermatol"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(93)70057-Z"},{"key":"e_1_2_5_10_2","first-page":"45","volume-title":"Diagnostic histopathology of tumors","author":"Calonje E","year":"2000"},{"key":"e_1_2_5_11_2","first-page":"889","volume-title":"Lever's histopathology of the skin","author":"Calonje E","year":"1997"},{"key":"e_1_2_5_12_2","first-page":"804","volume-title":"Pathology of the skin","author":"Cooper PH","year":"1990"},{"key":"e_1_2_5_13_2","first-page":"641","volume-title":"Soft tissue tumors","author":"Enzinger FM","year":"1995"},{"key":"e_1_2_5_14_2","first-page":"943","volume-title":"The skin","author":"Strutton G","year":"1992"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199702000-00004"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1979.tb06207.x"},{"key":"e_1_2_5_17_2","first-page":"715","volume-title":"Histologic diagnosis of inflammatory skin diseases","author":"Ackerman AB","year":"1978"},{"key":"e_1_2_5_18_2","first-page":"54","article-title":"Kaposi's sarcoma\u2010associated herpesvirus: a lymphotropic human herpesvirus associated with Kaposi's sarcoma, primary effusion lymphoma and multicentric Castleman's disease","volume":"14","author":"Cesarman E","year":"1997","journal-title":"Semin Diagn Pathol"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198102053040603"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1985.tb02997.x"},{"key":"e_1_2_5_21_2","first-page":"73","volume-title":"Muir's textbook of pathology","author":"Lindop GBM","year":"1992"},{"key":"e_1_2_5_22_2","first-page":"295","article-title":"The relationship of intracellular pathways of iron metabolism to cellular iron overload and the iron storage diseases. 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